ABSTRACT
médicos anestesiologistas, a sedação é um item de conforto do paciente, e diversas vezes menosprezada. O centro cirúrgico apresenta estímulos que podem ser danosos aos pacientes enquanto submetidos a anestesia regional sem uma adequada sedação, e estes podem gerar repercussões leves, como medo de novas anestesias, ou mais graves, como traumas permanentes. Este estudo avaliou a prevalência de sensações desagradáveis (álgica, térmica, proprioceptiva e auditiva) em pacientes submetidos a anestesia regional associados ou não a sedação. Foi realizado um estudo transversal onde foram entrevistados 184 pacientes no pós-operatório imediato. Informações demográficas e sensitivas foram coletadas e a análise estatística realizada utilizando o programa SPSS® versão 17.0. Os dados foram descritos utilizando prevalência eaplicados os testes do qui-quadrado ou índice de correlação de Pearson, com p<0,05. O risco relativo em relação ao gênero e ao uso de opióide como parte da sedação foi estimado com intervalo de confiança de 95%. Estudo aprovado pelo Comitê de Ética em Pesquisa do Hospital Governador Celso Ramos. Dos 184 pacientes, 53% relataram algum estímulo sensitivo ou auditivo, 16.8% sentiram frio ou calor durante o procedimento, 20% sentiram algum tipo de dor na realização do bloqueio. Não foi observada diferença estatística com o uso de opióide. Pacientes do gênero feminino relataram com mais frequência dor/desconforto na realização do bloqueio em comparação com o gênero masculino, porém sem diferença estatística ( p= 0,057).
Many surgical procedures are performed under regional anesthesia, and the patient's understanding of the type of anesthesia that will be performed may become impaired. The surgical center presents other types of stimuli that may be harmful to patients while undergoing regional anesthesia without adequate sedation, and these may generate mild repercussions, such as fear of new anesthetics, or more serious, such as permanent trauma. This study evaluated the prevalence of unpleasant sensations (pain, thermal, proprioceptive and auditory) in patients submitted to regional anesthesia associated with sedation. A cross-sectional study was conducted in which 184 patients were interviewed in the immediate postoperative period. Demographic and sensory information was collected and statistical analysis performed using SPSS ® version 17.0. The data were described using prevalence and when possible applied chi-squareand Pearson correlation coefficient, with p <0.05. The relative risk for gender and opioid use was estimated with a 95% confidence interval. Study approved by the Comitê de Ética of Hospital Governador Celso Ramos. Of the 184 patients, 53% reported some sensory or auditory stimuli. 16.8% felt cold or hot during the procedure, 20% felt some type of pain in the blockade and reported it in the postoperative period. It was not observed statistic difference related to opioid use. Female patients reported more pain / discomfort in the blockade compared to males, but there was no statistical difference (p = 0.057).
ABSTRACT
Leptospirosis is a spirochetal bacterial infection of great public health importance. It has a broad spectrum of clinical manifestations which goes from subclinical infection and self-limited anicteric febrile illness (80-90 percent of all cases) to icteric leptospiropirosis known as Weil's disease. This is a severe disease characterized by hemorrhage, acute renal failure and jaundice. It is uncommon for leptospirosis to present itself as a primary neurological disease. Additionally, acute pancreatitis is an unusual gastrointestinal manifestation. We report a case of leptospirosis presenting as ascending progressive leg weakness and complicating with acute pancreatitis in an adult patient treated at Hospital Universitário, Universidade Federal de Santa Catarina. The diagnosis was confirmed through ELISA-IgM antibody testing positive for leptospirosis. After antibiotic therapy and support treatment for a few weeks, total resolution of severe manifestations was achieved. Rare and unusual presentations of leptospirosis should be kept in mind in relevant epidemiological scenario.