RESUMO
Analyze the level of consciousness by means of the Aldrete-Kroulik scale associated with the use of oxygen therapy at the Post-Anesthesia Care Unit (PACU). It is a prospective and comparative study, with quantitative analysis. It was conducted in a big Federal Public Hospital, located in Belo Horizonte city. The sample was consisted of 60 subjects, separated between groups using and do not using oxygen therapy, aged between 18 and 64 years old, submitted to elective surgery, surgical site in upper torso, under general anesthesia, and with the American Society Anesthesiologists (ASA) status I or II. The most part of the patients were female, with 50 years old or older, classified as ASA II, under total intravenous anesthesia, and length of time of anesthesia over 240 minutes. In the analysis of the level of consciousness related to the use of oxygen therapy, it is noteworthy that the p-value (0.069) is significant at the 15 minutes of permanence in the PACU. A large number of patients from the group that received supplemental oxygen therapy showed improvement in the level of consciousness at the 15 minutes of permanence in the PACU. Team work is necessary to prevent patient's complications in anesthetic recovery period.
Analyze the level of consciousness by means of the Aldrete-Kroulik scale associated with the use of oxygen therapy at the Post-Anesthesia Care Unit (PACU). It is a prospective and comparative study, with quantitative analysis. It was conducted in a big Federal Public Hospital, located in Belo Horizonte city. The sample was consisted of 60 subjects, separated between groups using and do not using oxygen therapy, aged between 18 and 64 years old, submitted to elective surgery, surgical site in upper torso, under general anesthesia, and with the American Society Anesthesiologists (ASA) status I or II. The most part of the patients were female, with 50 years old or older, classified as ASA II, under total intravenous anesthesia, and length of time of anesthesia over 240 minutes. In the analysis of the level of consciousness related to the use of oxygen therapy, it is noteworthy that the p-value (0.069) is significant at the 15 minutes of permanence in the PACU. A large number of patients from the group that received supplemental oxygen therapy showed improvement in the level of consciousness at the 15 minutes of permanence in the PACU. Team work is necessary to prevent patient's complications in anesthetic recovery period.
Assuntos
Oxigenoterapia , Período de Recuperação da Anestesia , Anestésicos Gerais , Transtornos da Consciência , Recuperação Demorada da AnestesiaRESUMO
En la anestesia balanceada se asocian medicamentos de diferentes grupos farmacológicos a fin de potenciar los efectos deseados de unos y otros, lo cual se logra con el uso simultáneo de estos a dosis bajas, minimizando los riesgos propios de la anestesia. Existen muchos protocolos evaluados en equinos pero aún quedan otros por valorar. Por lo anterior, el objetivo de este estudio fue evaluar tres protocolos de anestesia balanceada en equinos sanos para determinar las características anestésicas logradas con cada uno. Se utilizaron cuatro equinos para probar los tres protocolos propuestos, dejando un periodo de descanso de 30 días entre uno y otro. Los resultados fueron analizados mediante un Anova y la prueba de Kruskal-Wallis para determinar la existencia de diferencias entre tratamientos. Los protocolos evaluados se comportaron de manera similar; las tres fases anestésicas fueron adecuadas en cuanto a calidad y tiempo; los parámetros fisiológicos no se afectaron considerablemente, y la inconsciencia e inmovilidad alcanzadas fueron suficientes lo que sugiere que son adecuados para la realización de procedimientos quirúrgicos de corta duración en equinos...
In balanced anesthesia, drugs from different pharmacological groups are associated in orderto enhance the desired effects of some and others, which is achieved by their simultaneoususe in low doses, minimizing the risks of anesthesia. There are many protocols evaluatedin horses but there are still others to evaluate. Therefore, the purpose of this study was toevaluate three balanced anesthesia protocols in healthy horses in order to determine theanesthetic properties achieved with each. Four horses were used to test the three proposedprotocols, leaving a resting period of 30 days between one and another. The results wereanalyzed by Anova and Kruskal-Wallis test to determine the existence of differences betweentreatments. The protocols evaluated behaved similarly; the three anesthetic phases were adequatein terms of quality and time; physiological parameters were not significantly affected,and the unconsciousness and immobility achieved were sufficient, which suggests that theyare suitable for short duration surgical procedures in horses...
Na anestesia balanceada se associam medicamentos de diferentes grupos farmacológicoscom o objetivo de potenciar os efeitos desejados de uns e de outros, isso se consegue com ouso simultâneo dos mesmos em doses baixas, minimizando os riscos próprios da anestesia.Existem muitos protocolos avaliados em equinos, mas ainda restam outros por avaliar. Porisso, objetivo deste estudo foi avaliar três protocolos de anestesia balanceada em equinos saudáveispara determinar as características anestésicas conseguidas com cada um. Utilizaramsequatro equinos para testar os três protocolos propostos, deixando um período de descansode 30 dias entre um e outro. Os resultados foram analisados mediante um Anova e o teste deKruskal-Wallis para determinar a existência de diferenças entre tratamentos. Os protocolosavaliados se comportaram de maneira similar; as três fases anestésicas foram adequadas noque diz respeito a qualidade e tempo; os parâmetros fisiológicos não foram afetados consideravelmente,e a inconsciência e imobilidade alcançadas foram suficientes o que sugere quesão adequados para a realização de procedimentos cirúrgicos de curta duração em equinos...
Assuntos
Animais , Anestesia , Anestesiologia , Anestésicos GeraisRESUMO
O diagnóstico de alergia a drogas é um dos mais difíceis procedimentos na área da imunoalergologia. As dificuldades prendem-se freqüentemente com o desconhecimento das circunstâncias em que ocorre a reação, com aspectos farmacológicos e metabólicos individuais e pela ausência de protocolos de diagnóstico estandardizados para grande número de drogas. A maioria das reações não é mediada por IgE, o que compromete a eficácia dos testes in vivo e in vitro disponíveis. A prova de provocação é comumente necessária na confirmação da reação adversa. Pelo risco de reação anafilática, o diagnóstico de alergia a drogas deve ser efetuado em meio hospitalar por uma equipe especializada com experiência nesta área. São realçados neste artigo os princípios gerais no diagnóstico de alergia a drogas e abordadas as particularidades na alergia a antibióticos, a anti inflamatórios não hormonais, anestésicos gerais, anestésicos locais, produtos de contraste iodados, corticosteróides sistêmicos e casos mais raros de síndrome de alergia a múltiplas drogas. É ainda apresentada a dessensibilização como uma opção terapêutica de exceção. De forma breve faz-se referência à experiência da Consulta de Alergia a Fármacos dos Hospitais da Universidade de Coimbra desde 1997.
Drug allergy diagnosis is one of the most difficult procedures in the area of immunoallergology. These difficulties are often due to: unknown of circumstance in which the reaction occurs, individual pharmacological and metabolic aspects and the inexistence of standardized protocols for the diagnosis of a great number of drugs. Most of drug reactions are not IgE mediated, which decrease the diagnostic efficacy of the available in vivo and in vitro tests. The challenge test is frequently needed for the diagnosis of adverse reaction. Due to the risk of anaphylactic reaction, drug allergy diagnosis must be performed in hospital environment, by a specialized team with experience in this field. In this article, we emphasis the general rules of drug allergy diagnosis and the particularities of allergy to antibiotics, nonsteroidal anti-inflammatory drugs, general anesthesics, local anesthesics, iodated contrast media, systemic corticosteroids and rare cases of multiple drug allergy syndrome. It is also presents desensitization as an exceptional therapy. We, briefly outline the experience of the Drug Allergy Outpatient Consultation Unit in Coimbra University Hospitais since 1997.