Restrictive versus Liberal Fluid Therapy for Post-Cesarean Acute Kidney Injury in Severe Preeclampsia: a Pilot Randomized Clinical Trial.

Objectives: The aim of this study was to determine whether a restrictive compared to a liberal fluid therapy will increase postoperative acute kidney injury (AKI) in patients with severe preeclampsia.

Methods: A total of 46 patients (mean age, 32 years; standard deviation, 6.8 years) with severe preeclampsia were randomized to liberal (1500 ml of lactated Ringer's, n=23) or restrictive (250 ml of lactated Ringer's, n=23) intravenous fluid regimen during cesarean section.

[Lean Six Sigma and anesthesia].

Background: Demands for health services have been growing sharply. Consequently, the costs of the institutions for their operational maintenance and investments also increase. The challenge of hospital management is to achieve standards of quality and safety for patients, increasing their productivity and minimizing costs.

Train-of-four recovery precedes twitch recovery during reversal with sugammadex in pediatric patients: A retrospective analysis.

Background: After reversal of a rocuronium-induced neuromuscular blockade with sugammadex, the recovery of train-of-four ratio to 0.9 is faster than recovery of first twitch of the train-of-four to 90% in adults. These findings after reversal of neuromuscular blockade with sugammadex have not yet been investigated in pediatric patients.

[Reversal of neuromuscular block with sugammadex in five heart transplant pediatric recipients].

Heart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block.

The effect of prior tetanic stimulation on train-of-four monitoring in paediatric patients: A randomised open-label controlled trial.

Background: In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus.

Objectives: The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.

Rocuronium and sugammadex in a 3 days old neonate for draining an ovarian cyst. Neuromuscular management and review of the literature.

A case is reported in which a 3-days old neonate with a giant ovarian cyst was scheduled for surgery. The patient received a dose of sugammadex to reverse a rocuronium-induced neuromuscular block. A fast and efficient recovery from neuromuscular block was achieved within 90s.

Oxytocin in cesarean-sections. What's new?

Oxytocin is the uterotonic agent of choice in the prevention and treatment of postpartum uterine atony. Nevertheless, there is no consensus on the optimal dose and rate for use in cesarean sections. The use of high bolus doses (e.

Sevoflurane preconditioning during myocardial ischemia-reperfusion reduces infarct size and preserves autonomic control of circulation in rats.

Purpose: To investigate the myocardial ischemia-reperfusion with sevoflurane anesthetic preconditioning (APC) would present beneficial effects on autonomic and cardiac function indexes after the acute phase of a myocardial ischemia-reperfusion.

Methods: Twenty Wistar rats were allocated in three groups: control (CON, n=10), myocardial infarction with sevoflurane (SEV, n=5) and infarcted without sevoflurane (INF, n=5). Myocardial ischemia (60 min) and reperfusion were performed by temporary coronary occlusion.

[Rocuronium and sugammadex in a 3 days old neonate for draining an ovarian cyst. Neuromuscular management and review of the literature].

A case is reported in which a 3-days old neonate with a giant ovarian cyst was scheduled for surgery. The patient received a dose of sugammadex to reverse a rocuronium-induced neuromuscular block. A fast and efficient recovery from neuromuscular block was achieved within 90s.

[Oxytocin in cesarean-sections. What's new?].

Oxytocin is the uterotonic agent of choice in the prevention and treatment of postpartum uterine atony. Nevertheless, there is no consensus on the optimal dose and rate for use in cesarean sections. The use of high bolus doses (e.

[Anesthesiology Journal club assessment by means of semantic changes].

Background And Objectives: The interactive approach of a journal club has been described in the medical education literature. The aim of this investigation is to present an assessment of journal club as a tool to address the question whether residents read more and critically.

Methods: This study reports the performance of medical residents in anesthesiology from the Clinics Hospital - University of São Paulo Medical School.

Anesthesiology Journal club assessment by means of semantic changes.

Background And Objectives: the interactive approach of a journal club has been described in the medical education literature. The aim of this investigation is to present an assessment of journal club as a tool to address the question whether residents read more and critically.

Methods: this study reports the performance of medical residents in anesthesiology from the Clinics Hospital - University of São Paulo Medical School.

Chronic pain after cesarean section. Influence of anesthetic/surgical technique and postoperative analgesia.

Background And Objectives: Brazil ranks second among countries with the highest rates of cesarean section in the world. Little is known about the future consequences of this procedure on maternal health. This study investigated the influence of anesthetic/surgical technique and postoperative analgesia on the onset of chronic pain after three months of cesarean section.

Anesthesiology teaching during undergraduation through an academic league: what is the impact in students' learning?

Background And Objectives: Academic leagues have been consolidated as instruments of medical teaching and for the introducing of medical students to practice of specialties, including anesthesiology. As the role of leagues in the development process of competencies and learning of their students is not well known, the learning of members of an anesthesiology academic league was evaluated after participating in its activities for one year.

Method: Students of an anesthesiology academic league were followed up from March to December 2010 and evaluated through objective cognitive tests of multiple choice applied before the beginning of activities and after their conclusion.

Correlation between the body mass index (BMI) of pregnant women and the development of hypotension after spinal anesthesia for cesarean section.

Background And Objectives: Very few publications correlate hypotension in obese pregnant women, and especially morbidly obese, after spinal anesthesia for cesarean section. The objective of the present study was to evaluate the incidence of hypotension according to the BMI.

Methods: Forty-nine patients with pregestational BMI below 25 kg.

Evaluation of a computerized anesthesia report.

Background And Objectives: In Brazil, the use of information systems that allows filling out anesthesia reports automatically is still in its initial stages. The objective of this study was to validate an automated anesthesia record.

Methods: This study was approved by the Ethics Commission of the institution; an industry-university partnership (Dixtal, São Paulo, Brazil and Universidade de São Paulo) was developed, and the study received a grant from FINEP (Financiadora de Estudos e Projetos do Ministério de Ciência e Tecnologia).

Peri-operative evaluation by holter in elderly patients submitted to prostatectomy.

Background: Male patients, aged over 65 years and with no history of heart disease, need the following tests as a preoperative evaluation: blood count, electrocardiogram and X-ray of the chest.

Objective: To verify the presence of ischemic and heart rate changes and the impact of the anesthetic procedure on these patients. Also to verify, in this population, the value of continuous ambulatory monitoring as a preoperative evaluation, a procedure that is not recommended by current guidelines.

[Supplemental oxygen and the incidence of perioperative nausea and vomiting in cesarean sections under subarachnoid block].

Background And Objectives: Supplemental oxygen can reduce the incidence of postoperative nausea and vomiting in patients under general anesthesia. The objective of the present study was to determine the efficacy of supplemental oxygen to reduce the incidence of perioperative nausea and vomiting in elective cesareans under subarachnoid block.

Methods: After induction of standardized subarachnoid block, 94 parturients undergoing surgical delivery were randomly divided to receive 4 L.

[Oxytocin in cesarean sections: what is the best way to use it?].

Background And Objectives: Oxytocin is the uterotonic used in obstetric anesthesia, and its prophylactic and therapeutic administration is justified because it reduces the incidence of post-partum hemorrhage. However, the ideal infusion regimen in elective cesarean sections has not been determined yet. The objective of this study was to review the main physiological and pharmacological characteristics of oxytocin and to discuss its rational use by anesthesiologists in view of its side effects.

[The effect of adding subarachnoid clonidine to hyperbaric bupivacaine and sufentanil during labor analgesia.].

Background And Objectives: Adding subarachnoid clonidine (an alpha -agonist) prolongs the analgesic effect of the combination of sufentanil and isobaric bupivacaine when combined during labor analgesia. The aim of this study was to compare the quality and duration of the analgesia as well as the incidence of side-effects after the addition of subarachnoid clonidine to hyperbaric bupivacaine and sufentanil in a combined spinal-epidural analgesia during labor.

Methods: Twenty-six patients, physical status ASA I in full-term pregnancy were studied.

[Anesthesia breathing systems with CO2 absorption, circle valve circuit: comparison of thermal behavior of coaxial system and conventional system with different fresh gas flows.].

Background And Objectives: The adequate maintenance of inhaled gases temperature during anesthetic procedures is critical to prevent perioperative respiratory complications. This study aimed at comparing the ability to warm up inhaled gases of coaxial breathing system and conventional system, by varying fresh gas flows (FGF).

Methods: Breathing systems were tested in a lung simulator ventilated with 600 mL tidal volume and respiratory frequency of 10 bpm.