Estudo comparativo entre atracúrio e vecurônio em dose única / Comparative study between atracurium and vecuronium using single dose

O estabelecimento do bloqueio neuromuscular do músculo adutor do polegar foi comparado após injeçäo única de atracúrio na dose de 0,6 mg kg e vecurônio na dose de 0,1 mg.kg em 23 pacientes ASA I e II sob anestesia geral. Foram avaliados os parâmetros de tempo desde o momento da injeçäo até a recuperaçäo da seqüência de quatro estímulos a 75% (Figura 1). Houve um aumento estatisticamente significativo de cerca de 10 min na duraçäo de açäo do atracúrio (p <0,05) em relaçäo ao vecurônio, assim como de outros parâmetros de tempo (Quadro 2). Näo ocorreram alteraçöes cardiocirculatórias (FC e PAM) nos 5 min subseqüentes às injeçöes de atracúrio e vecurônio. Foi observado um caso de eritema sobre o trajeto venoso no grupo que recebeu atracúrio. O atracúrio e o vecurônio säo bloqueadores neuromusculares indicados para cirurgias com duraçäo igual ou menor que 1 h

[Clinical use in adults of 2 new muscle relaxants: atracurium and vecuronium]. / Utilisation clinique chez l'adulte de deux nouveaux myorelaxants: l'atracurium et le vécuronium.

115 general and urologic surgery adult patients, ASA class I-II, were divided in four groups according to initial bolus and relaxant used: group A atracurium 0.6 mg X kg-1, group B 0.5 mg X kg-1, group C vecuronium 0.1 mg X kg-1 and group D pancuronium 0.1 mg X kg-1. When the single twitch recovered to 25% of control height (T25), subgroups were individualized depending on whether repeat doses of 1/3 of initial bolus were given or not, and whether reversal was spontaneous or obtained by a standard dose of neostigmine 2.5 mg and atropine 1.25 mg. By ulnar nerve stimulation at the wrist, the force of thumb adduction was recorded on a polygraph; single twitch (tw), train of four (tof) and ratio tof 4/1 (Rtof) were measured. Anaesthesia was induced with thiopentone and fentanyl without premedication and maintained with fentanyl and N2O in oxygen; the trachea was intubated once the block was at its maximum. The onset time of maximal block was 5 min for groups A, B and C, and 7.9 min for group D. T25 was 39.9 +/- 8.5 min for group A, 34.4 +/- 9.7 min for group B, 28.9 +/- 9.9 min for group C and 70.7 +/- 25.9 min for group D. A Rtof equal to 75% was achieved in less than 65 min with atracurium and vecuronium, but much later with pancuronium. Reversal at T25 was efficient, but not really required, for atracurium and vecuronium, but necessary and useful for pancuronium.(ABSTRACT TRUNCATED AT 250 WORDS)

Sistemas anti-poluicao. / Anti-pollution systems

E sabido que a exposicao cronica dos gases e vapores anestesicos das pessoas que trabalham em sala de operacoes, pode levar a uma serie de efeitos indesejaveis.Assim, sao apresentados de maneira sucinta e objetiva os sistemas utilizados para controle de poluicao do meio ambiente pelos anestesicos inalatorios

Vaporizadores. / Vaporizers

A utilizacao segura dos anestesicos volateis implica entre outros fatores, a escolha apropriada do equipamento, e do conhecimento de seus principios basicos de funcionamento. Sao apresentados, de modo sumario, os principios e os mecanismos de funcionamento dos vaporizadores, detalhando aqueles mais utilizados em nosso meio

[Epidural morphine for obstetrical pain relief (author's transl)]. / Hypoalgésie obstétricale par injection péridurale de morphine.

Twenty five healthy pregnant women received an epidural injection (at levels varying from T11-T12 to L3-L4) of morphine (2 or 3 mg in 10 ml of saline solution 9 p. thousand) in order to achieve pain relief for delivery. The degree of dilation never exceeded 5 cm at time of injection. Pain level decreased in 22 cases (88 p. cent) but only 16 women (64 p. cent) were fully satisfied. Hypoalgesia begun after 25 minutes and disappeared after 19 hours. No respiratory or haemodynamic changes were noted. On the other hand, the duration of the first stage of labour decreased. The best results are seen when injection is achieved at highest levels, facing spinal cord segments supplying the cervix and the perineum. No newborn showed any sign of respiratory or neurologic depression.

[Comparative study about the analgesic effect of buprenorphine (author's transl)]. / Etude sur l'efficacité analgésique de la buprénorphine.

In that study we compared the analgesic effects of equianalgesic doses of buprenorphine and morphine taken as the narcotic of reference. The experiment has been undertaken in ten adults having severe cancer pain. The results have been analysed by statistical non parametric tests. We found that buprenorphine and morphine have the same pattern of action despite the fact that intramuscular buprenorphine has a clinical duration of approximately 9 hours.

[Pain due to bone metastasis in hormonodependent cancer. Treatment by intrasellar injection of alcohol (author's transl)]. / Les douleurs des cancers métastasés hormono-dépendants. Leur traitement par l'hypophysiolyse à l'alcool.

Pain due to bone metastasis in hormonodependent cancer (of the breast or the prostates more particularly) can be relieved by surgery directed at the endocrinic system. The most efficient techniques are hypophysectomies and hypophysiolysis (or neuroadenolysis). The intrasellar injection of alcohol through the transnasal-transsphenoidal route is a fairly simple procedure which can be carried out on such fragile patients without too much risk. The authors here report the first results obtained with this procedure in 12 pateints. Full sedation of pain is achieved in 30 to 40 p. cent of the cases. The duration of analgesia varies and pain frequently returns. One of the advantages of this procedure lies in the fact that such an injection may be repeated if necessary. The intrasellar injection of alcohol is but one of the many techniques available to practitioners working in the field of intractable pain.