Suprascapular nerve block: important procedure in clinical practice. Part II.

The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II). The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures.

Suprascapular nerve block: important procedure in clinical practice.

Background And Objectives: Shoulder pain is a frequent complaint that results in great functional disability in the affected shoulder as well as the decrease in patients' quality of life. Suprascapular nerve block is an effective therapeutic method and has been increasingly used by anesthesiologists both for regional anesthesia and postoperative analgesia of surgeries carried out in this articulation, which justifies this review, whose main purpose was to describe the applied technique and clinical indications.

Content: It is presented the anatomy of suprascapular nerve, since its brachial plexus origin until its terminal branches, as well as general characteristics and technique employed to carry out the block of this nerve, main drugs used, volume and situations that give rise to its applications.

Relevant aspects of coronary artery disease in candidates for non-cardiac surgery.

Background And Objectives: Due to its prevalence, coronary artery disease (CAD) represents the main cause of morbidity and mortality in elective surgeries, which justifies this review, whose objective was to establish preoperative conducts based on rules and directive to minimize peri- and postoperative morbidity and mortality of patients with CAD.

Contents: General characteristics of CAD, as well as its physiopathogenic mechanisms, the main variables related to preoperative care of patients with CAD, and the conducts for patients with greater surgical risk are presented.

Conclusions: Patients with CAD who are candidates for non-cardiac surgeries should be evaluated judiciously.

[Pulmonary function after laparoscopic cholecystectomy and abbreviated anesthetic-surgical time].

Objective: To evaluate pulmonary function after laparoscopic cholecystectomies.

Methods: Prospective study, in which the post-operative spirometries of 15 patients who underwent laparoscopic cholecystectomies with abbreviated anesthetic-surgical time were analyzed.

Results: Significant differences existed for the Forced Vital Capacity variable (p=0,020) and Forced Expiratory Volume in the first second (p=0,022) between pre- and immediate post-operative, indicating restrictive ventilatory disturbances.

[Functional respiratory repercussion in opened subcostal cholecystectomy: analgesic effect of morphine].

Objective: To evaluate pulmonary function after open subcostal cholecystecomy under action of the morphine in the immediate post-operative.

Methods: This was a prospective study, in which the post-operative spirometries of fifteen patients who underwent open subcostal cholecystectomies which received peridural morphine anesthesia. Post- and pre-operative data were compared using a paired student-t test.

Neuropathic pain after epidural needle trauma.

Background And Objectives: Neurologic complications secondary to epidural block are uncommon. Direct mechanical trauma to nerve roots may cause neuropathic pain that, usually, has a favorable evolution; however, it is a potentially severe complication that can evolve into a chronic disorder. The objective of this study was to discuss acute traumatic neuropathic pain and, especially, its treatment.

[The influence of epidural morphine in the pulmonary function of patients undergoing open cholecystectomy].

Background And Objectives: Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine.

Methods: In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each.

[Peri-operative management of amiodarone patients.].

Background And Objectives: Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures.

[Artificial cardiac pacemaker: pre and intraoperative considerations.].

Background And Objectives: Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure.

[Preoperative assessment of lung disease patients.].

Background And Objectives: Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients.