Cardiac dysrhythmias and anesthesia.

Background And Objectives: Cardiac dysrhythmias are relatively common in the perioperative period and should be adequately diagnosed and treated by the anesthesiologist whenever indicated. The objective of this article was to review the most relevant aspects of cardiac dysrhythmias, as well as establishing the cause-effect relationship between drugs used in the perioperative period and dysrhythmias.

Contents: The mechanisms of dysrhythmias, drugs that can potentially cause dysrhythmias, besides diagnosis and treatment in the perioperative period are presented.

Anesthesia for surgical correction of coronary artery fistula without extracorporeal circulation: case report.

Background And Objectives: Described by Krause in 1865 (1), coronary artery fistula communicating with cardiac cavities, pulmonary artery, or coronary sinus is very rare. It represents 0.2% to 0.

[Intraoperative volume replacement: crystalloids versus colloids in surgical myocardial revascularization without cardiopulmonary bypass].

Background And Objectives: The use of crystalloids or colloids for volume replacement in large size surgeries is controversial. The objective of this study was to compare the effects of the intraoperative administration of crystalloids (normal saline - NS) with those of colloids (modified fluid gelatin) for surgical myocardial revascularization (SMR) without cardiopulmonary bypass (CPB).

Methods: Forty patients undergoing SMR without CPB were randomly divided in two similar groups.

Anesthesia for endovascular surgery of the abdominal aorta.

Background And Objectives: Endovascular surgery for aneurism of the aorta is less invasive than the conventional procedure besides other advantages such as the absence of abdominal incision, absence of ligature of the aorta, and reduced postoperative recovery time. Since it is a relatively new procedure and to presenting a series of changes that should be known by the anesthesiologist, the objective of this report was to review the most relevant aspects of endovascular surgery, allowing more adequate perioperative anesthetic management.

Contents: A brief description of the technique of endovascular aneurism repair, possible vantages and disadvantages of its use, as well as potential complications are discussed.

Anesthesia for Blalock-Taussig shunt and pacemaker placement in an adult patient with univentricular heart. Case report.

Background And Objectives: Univentricular heart is a complex, rare, and severe cardiopathy, with no possibility of curative surgical treatment, associated with a high mortality in the first years of life. The objective of this article was to describe a rare case of an adult patient with uncorrected single ventricle who was admitted for pulmonary valvuloplasty but was submitted to a modified Blalock-Taussig and placement of an epicardic pacemaker. The complementary objective of this report was to address the anesthetic particularities of adult patients with uncorrected congenital cardiopathy.

Right atrial myxoma associated with acute cor pulmonale. Case report.

Background And Objectives: Atrial myxomas are the most common type of primary intracardiac tumors. Although they are benign, it is recommended its immediate removal as soon as the diagnosis is confirmed, since they are associated with tumor embolization and their harmful consequences. The objective of this report was to present the case of an intracardiac tumor of rare location (right atrium) that developed intraoperative embolization and to alert anesthesiologists for the possibility of this complication, besides discussing the anesthetic conduct.

[Anesthesia for treatment of cardiac aspergillosis in a patient with thrombocytopenia and the judicious use of aprotinin.].

Background And Objectives: Aprotinin has been widely used in cardiac surgeries as a therapeutic resource for reducing the effects of cardiopulmonary bypass (CPB) on coagulation and fibrinolysis. Recovery of adequate hemostasia at the end of the procedure is one of the objectives of the anesthesiologist. However, aprotinin has specific indications.

[Anesthesia and the long QT syndrome.].

Background And Objectives: Cardiac arrhythmias are important factors of perioperative morbidity and mortality. Among the causes of arrhythmias, the long QT syndrome, both in the genetic and acquired types, should be remembered since several drugs used in anesthesia, as well as in the perioperative period, can prolong the QT interval and trigger potentially malignant arrhythmias.

Contents: A review of the long QT syndrome (LQTS), discussing its causes and definition, as well as the mechanisms of the disease.

[Anesthesia for repair of tetralogy of Fallot in an adult patient: case report.].

Background And Objectives: Congenital cardiopathy is one of the most common problems at birth, with an incidence of 1 to 1.5 in 10,000 live births. Currently, more than 85% of children with congenital cardiopathy survive to adulthood, partly due to the development of new therapies, but especially because of the tendency for earlier surgical corrections.

[Intra - and postoperative tremors: prevention and pharmacological treatment].

Background And Objectives: Tremors can be an adverse effect of the surgical intervention and anesthesia. The incidence of postoperative tremors varies from 6.3% to 66%.

[Anesthesia for morbid obesity.].

Background And Objectives: Morbid obesity is very frequent in our society, having achieved the level of an epidemic in the United States. Obese patients present several physiopathologic changes and important comorbidities, which the anesthesiologist must be aware of. Gastric reduction surgery is increasingly more frequent, and the perioperative period has unique characteristics, with cardiovascular and pulmonary changes that make it a real challenge for the professional involved.

Anesthesia for endoscopic ventriculostomy for the treatment of hydrocephalus. Case report.

Background And Objectives: Endoscopic third ventriculostomy is becoming routine among neurosurgical pediatric procedures. However, reports on anesthesia for children undergoing such procedures are rare. The aim of this series of cases was to demonstrate the precautions that should be taken and efficacy of the method used.

[Accidental spinal block during vertebral artroplasty: case report.].

Background And Objectives: Vertebral artroplasty with bone cement has its particularities and complications. Most often the procedure is performed under local anesthetic and sedation, but sometimes it is done under subarachnoid or epidural block with morphine to achieve postoperative analgesia. The objective of this report is to discuss the possible complications of vertebroplasties.

[Systemic hypertension and anesthesia.].

Background And Objectives: Due to the high incidence of systemic hypertension and the lack of consensus on pressure levels to be accepted before inducing anesthesia for elective procedures, literature associated to hypertension and anesthesia was reviewed. Considering that canceling a surgery implies expenses making Medicine increasingly more expensive and that, on the other hand, anesthesia should be induced in the safest possible manner, this study aimed at evaluating literature evidences to orient clinical practice.

Contents: Incidence and classification of systemic hypertension in addition to reports and comments on relevant studies approaching hypertension in surgical patients are presented.