[Anesthetic complications in a rehabilitation hospital: is the incidence related to the pre-anesthetic visit?].

Introduction: Approximately 234 million surgeries are done annually worldwide. There is a growing concern for the safety of the anesthetic act, and the pre-anesthetic consultation emerges as an important and widely recommended activity, used as a preventive measure for the emergence of a complication.

Objectives: To describe the complications related to anesthesia, to identify the factors that contribute to its appearance and to reflect on ways to improve clinical practice.

Incidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anesthetic technique?

Background And Objectives: Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy refers to a set of signs and symptoms that include pain, increased sweating, and vasomotor instability. Pain is usually triggered by a noxious stimulus in a peripheral nerve, which is disproportionate to the triggering stimulus. Its development after surgery is not uncommon varying with the type of intervention.

Effect of isolated anticonvulsant drug use and associated to midazolam as pre-anesthetic medication on the Bispectral Index (BIS) in patients with cerebral palsy.

Background And Objectives: Patients with cerebral palsy (CP) frequently receive drugs for the treatment of concomitant diseases, such as seizures. Midazolam is a benzodiazepine with hypnotic action most often used as pre-anesthetic medication and its drug interactions in patients with CP are unknown. The objective of the present study was to evaluate the effect of midazolam as pre-anesthetic drug on the BIS of patients with CP undergoing chronic treatment with anticonvulsant agents.

Influence of angiotensin-converting enzyme inhibitors on hypotension after anesthetic induction: is the preoperative discontinuation of this drug necessary?

Background And Objectives: The discontinuation of drugs such as angiotensin-converting enzyme inhibitors (ACE inhibitors) has been suggested based on reports of hypotension during anesthesia. This may imply on a higher risk of intraoperative hypertensive peaks with deleterious consequences for the patient. The objective of the present study was to evaluate the influence of the preoperative use of ACE inhibitors on the development of hypotension during anesthesia.

Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block.

Background And Objectives: Correction of congenital clubfoot (CCF) is associated with severe postoperative pain. Caudal epidural block associated with general anesthesia is the anesthetic technique used more often in children, but it is limited by the short duration of the postoperative analgesia. Peripheral nerve blocks are associated with a low incidence of complications and prolonged analgesia.

Epidural lumbar block or lumbar plexus block combined with general anesthesia: efficacy and hemodynamic effects on total hip arthroplasty.

Background And Objectives: Anesthesia for total hip arthroplasty (THA) is a challenge due to the advanced age and associated diseases of patients. The objective of this study was to evaluate whether the efficacy of the nociceptive blockade, secondary hemodynamic effects, difficulty to execute the technique, and influence in intraoperative bleeding of lumbar plexus block combined with general anesthesia is equivalent to epidural lumbar block in patients undergoing THA.

Methods: Patients with physical status ASA I to III were randomly separated into two groups, Epidural and Lumbar.

[Effects of epidural analgesia and continuous lumbar plexus block on functional rehabilitation after total hip arthroplasty].

Unlabelled: BAKGROUND AND OBJECTIVES: Pain after total hip arthroplasty (THA) is severe and it is aggravated by movements, which requires an effective analgesic technique that allows early mobilization, participation in rehabilitation activities, and fast functional recovery. The objective of this study was to compare the effects of epidural and perineural patient-controlled analgesia (PCA) of the lumbar plexus on functional rehabilitation of patients undergoing THA.

Methods: Patients classified as physical status ASA I to III were randomly divided into two groups: Epidural and Lumbar.

[The incidence of postoperative respiratory depression in patients undergoing intravenous or epidural analgesia with opioids].

Background And Objectives: Intravenous or epidural patient-controlled analgesia (PCA) is a safe and effective technique in the treatment of postoperative pain. However, the use of opioids is not devoid of risks,and respiratory depression represents the most feared complication. The objective of the present study was to describe the incidence of respiratory depression associated with postoperative analgesia with the intravenous or epidural administration of opioids and the characteristics of the patients who developed this complication.

Posterior lumbar plexus block in postoperative analgesia for total hip arthroplasty: a comparative study between 0.5% Bupivacaine with Epinephrine and 0.5% Ropivacaine.

Background And Objectives: Posterior lumbar plexus block promotes effective postoperative analgesia in total knee arthroplasty. Ropivacaine and bupivacaine do not show differences in analgesic efficacy when used in different peripheral nerve blocks. The objective of this study was to compare the efficacy of postoperative analgesia resulting from the administration of a single dose of 0.

Thoracic epidural block performed safely in anesthetized patients. A study of a series of cases.

Background And Objectives: The development of paraplegia following the insertion of epidural catheter in anesthetized patients raised questions by some authors about the procedure, even without the confirmation that the lesion occurred because the patient was anesthetized. For this reason, we designed this study, with the objective to evaluate the frequency of neurological complications and development of sequelae after thoracic epidural block in patients under general anesthesia.

Methods: Patients undergoing thoracic surgeries from 02/16/2004 to 05/30/2006 participated in the study.

Patients with sequelae of poliomyelitis. Does the anesthetic technique impose risks?

Background And Objectives: Several questions arise before performing neuro-axis block in patients with sequelae of poliomyelitis. Reports in the literature are scarce. The objective of this study was to describe the anesthetic techniques used in patients undergoing surgeries and possible complications.

When the bispectral index (bis) can give false results.

Background And Objectives: The bispectral index (BIS) is a multifactorial parameter derived from the electroencephalogram (EEG), which allows monitoring of the hypnotic component of anesthesia. It was obtained from the algorithm based on the analysis of a large number of EEGs from volunteers and patients undergoing sedation and general anesthesia with different anesthetic agents. The use of BIS to monitor the depth of anesthesia reduces the incidence of intraoperative awakening and recall, among other benefits.

Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy. A comparative study on the variations of the bispectral index.

Background And Objectives: Midazolam is a benzodiazepine with hypnotic action widely used as pre-anesthetic medication in pediatric anesthesia. Children with cerebral palsy (CP) also benefit from the use of midazolam, but its effects on this group of patients, who present several particularities, including changes at the site of action of midazolam, are still unknown. The objective of this study was to evaluate the effects of midazolam, when used as pre-anesthetic medication, on the bispectral index (EEG-BIS) of patients with cerebral palsy.

Postoperative continuous plexular analgesia. A study on the side effects and risk factors of catheter infection.

Background And Objectives: The importance of postoperative analgesia has increased over the years. Plexular catheters represent a good option for high quality analgesia with reduced systemic repercussions. The objective of the present study was to evaluate the incidence of side effects and complications in postoperative analgesia with plexular catheters and identify risk factors for bacterial colonization of the catheters.

[Respiratory complications in patients with cerebral palsy undergoing general anesthesia.].

Background And Objectives: Anesthesia in patients with cerebral palsy (CP) poses a challenge for the anesthesiologist. The objective of this prospective study was to determine the prevalence and risk of respiratory complications in children with CP undergoing general inhalational anesthesia for computed tomography.

Methods: Patients with ages ranging from 1 to 17 years, physical status ASA I to III, undergoing general inhalational anesthesia with sevoflurane and laryngeal mask for a CT scan from June 2002 to June 2003, participated in this study.

[Comparison of the bispectral index in awake patients with cerebral palsy].

Background And Objectives: The EEG-BIS was created after studies in healthy adult subjects, and studies in children were first published in 1998. Cerebral palsy (CP) is secondary to a static lesion of the developing brain. The need to perform exams and surgical procedures to correct deformities, under anesthesia or sedation, is common in these patients.

Postoperative urinary retention: evaluation of patients using opioids analgesic.

The study aimed to determine the occurrence of urinary retention in patients using opioid analgesic and to describe the method used for vesical relief. A prospective and consecutive series of 1,316 patients undergoing surgery from September 1999 to April 2003 and using opioids post surgery were studied. From the 1,136 patients, 594 did not use urinary catheters pre-surgery.

[Neurological complications and damage of regional block in children under general anesthesia: a real problem or sporadic cases?].

Background And Methods: It has been questioned whether regional block in children, which most of the time is done under general anesthesia, is really safe. There is the potential risk of permanent or temporary neurological damage when the patient cannot complain of eventual paresthesia or pain while the block is being performed, making anesthesiologists very insecure. The aim of this study was to evaluate the prevalence of neurological complications and damage of regional block in children under general anesthesia.

[Total spinal block after posterior lumbar plexus blockade: case report.].

Background And Objectives: Lumbar plexus blockade can be very useful in surgical procedures of the hip, thigh, and knee, but it should be performed by an experienced anesthesiologist due to potential complications. The current report presents a case of total spinal block after posterior lumbar plexus blockade and discusses the possible pathophysiological mechanisms.

Case Report: Male patient, 34 years old, 97 kg, physical status ASA I, scheduled for total hip arthroplasty.

[Regression of general anesthesia in patients with cerebral palsy: a comparative study using the bispectral index.].

Background And Objectives: It has been said that patients with cerebral palsy (CP) present a higher sensitivity to anesthetic agents, which may affect adversely the awakening from anesthesia. The objective of this study was to evaluate the recovery of patients with CP compared with patients without CNS disease.

Methods: The study population was composed of children ages 5 to 15, divided in two groups: those with a diagnosis of cerebral palsy and those without CNS disease.

[Immobility: essential inhalational anesthetics action.].

Background And Objectives: Immobility is an essential component of general anesthesia and should be looked for and maintained throughout anesthesia. Anesthetic potency, called Minimum Alveolar Concentration (MAC), results from the inhibition of movement response to noxious stimulation. However, although spinal cord is recognized as the primary mediator of surgical immobility, cellular and subcelular mechanisms of action of inhaled anesthetics to produce immobility are not yet totally known.

[Preventing toxic substances production during carbon dioxide absorption by soda lime with halogenate anesthetics.].

Background And Objectives: Since the beginning, soda lime use has presented some complications which resulted in its difficult application. However major advantages such as decreasing fresh gas flow, anesthetic consumption and operating room pollution, and improving breathing system and airway humidity, have pushed research forward to improve it and assure the continuity of its use. Currently, there are problems with dehydration, increased temperature and metabolic degradation of halogenate agents, which require special care to prevent toxic substances formation.

[Continuous epidural analgesia: analysis of efficacy, side effects and risk factors.].

Background And Objectives: Epidural analgesia with local anesthetics and opioids has a reputation of high efficacy with low incidence of side effects. This study aimed at determining incidence, type and severity of postoperative complications related to epidural analgesia and catheter insertion.

Methods: Participated in this retrospective study 469 patients submitted to postoperative epidural analgesia in the period 10/18/99 to 10/18/01.

[Management of pain in patient with inoperable sacral tumor: case report.].

Background And Objectives: Different techniques may be used to control cancer pain. This report aimed at describing some therapeutic measures used to treat a patient with a severe and bad responsive pain.

Case Report: A 70-year-old male patient a sacral chordoma of very difficult therapeutic.

[Desflurane: physicochemical properties, pharmacology and clinical use.].

Background And Objectives: Following the development of nuclear chemistry with halogenate synthesis in the 50s of past century, several anesthetics were clinically studied and some of them had wide practical application. The search for the ideal agent continues. Currently, halothane, isoflurane, enflurane, sevoflurane and desflurane are in clinical use.