Choque hemorrágico controlado e expressão da proteína Fos em medula espinhal de ratos após estímulo nociceptivo periférico / Controlled hemorrharig shock and Fos protein expression in rats spinal cord after perifheric nocicepptive stimuli

Grande variedade de eventos estressantes pode ativar mecanismos de controle endógeno de dor e produzir analgesia. Avaliamos o efeito do choque hemorrágico controlado tratado e não tratado, PAM de ± 40mmHg, na expressão de Fos na medula espinhal de ratos após estímulo nociceptivo periférico com 50 µl de formol à 5 por cento na pata posterior. Duas horas após a injeção de formol a medula foi removida. Secções foram preparadas, processadas para imuno-histoquímica, e contados os neurônios Fos-positivo nas lâminas de Rexed ipsolaterais ao estímulo nociceptivo de L4-L5. A expressão de Fos foi maior nas condições de normotensão, quando comparada com as de choque, e foi menor no choque não tratado quando comparado com o tratado. Provavelmente a diminuição da sensibilidade dolorosa ocorreu devido ao choque hemorrágico / A great range of stressful events may activate the mechanisms of pain endogenous control and produce analgesia. In this study was evaluated the treated and non treated controlled hemorrhagic shock with mean blood pressure ± 40 mmHg effects in the expression of Fos in rat spinal cord after peripheric nociceptive stimuli with 50 µl of formalin 5 per cent in the rear paw. 2 hours after the injection of formalin the spinal cord was removed. There were prepared sections and processed to immunohistochemistry and Fos-positive neurons were counted on the same side to nociceptive stimuli. The Fos expression was more significant in normotension when compared with shock conditions, and was less in non treated shock compared with the treated. The results suggest that the decrease of pain sensitivity occurred due to the hemorrhagic shock...

Anestesia para colecistectomia laparoscópica: avaliaçåo das alteraçöes respiratórias / Anesthesia for laparoscopic cholecystectomy: evaluation of respiratoy changes

The purpose of this study was evaluate the respiratory chnges of 24 ASA I OR II patients undergoing laparoscopic cholecystectomy under controlled mechanic ventilation. The anesthetic induction was performed with fentanyl (0.003-0.004 mg/kg), propofol (2-3 mg/kg), atracurium (0,5 mg/kg) and maintained with halothane and nitrous oxide (1:1). The respiratory pattern was adjusted to: tidal volume=10 ml/kg; respiratory rate= 10/min; I/E= 1/2. The endotracheal (PET) and intra-abdominal pressure,the oxygen saturation (SpO2) and end CO2 (PET CO2) were studied. These parameters were registred 1 minute after tracheal intubation (T0), 1 minute after insuflation of the peritoneal cavity (T1) and afterwards every 10 minutes. The oxygen saturation values were maintained within normal limits during the procedure. The endotracheal pressure increased significantly after insuflation of the peritoneal cavity (p=0,0001), while the values of the end tidal C02 incresead at T4 and T5, when compared with T0. The authors concluded that controlled mechanic ventilation along with an appropriate monitoring of the patient must be taken into account in order to prevent respiratory disturbances and its adverse effects