RESUMEN
BACKGROUND AND OBJECTIVES: The objective of the present study was to evaluate the degree of sedation, intraocular pressure, and hemodynamic changes with premedication with low doses of oral clonidine, 100 microg and 200 microg, in outpatient cataract surgeries. METHODS: This is a randomized, double-blind, clinical study undertaken at the Universidade Federal de São Paulo with 60 patients of both genders, physical status ASA 1 and 2, ages 18 to 80 years. Patients were separated into three groups: placebo, clonidine 100 microg, and clonidine 200 microg. Intraocular pressure, heart rate, and blood pressure besides assessment of sedation were measured before and 90 minutes after the administration of clonidine. Sedation levels were classified according to the Ramsay sedation scale. RESULTS: Patients who received placebo and 100 microg of clonidine did not show reduction in heart rate, while a reduction in heart rate was observed in patients who received 200 microg of clonidine, and this difference was statistically significant. Patients who received 200 microg of clonidine also had a reduction in systolic and diastolic blood pressure (p < 0.05). One patient who received 200 microg of clonidine developed severe hypotension, with systolic pressure < 80 mmHg. Patients treated with clonidine had a reduction in intraocular pressure (p < 0.05). Ninety minutes after the oral administration of placebo and 100 microg and 200 microg of clonidine, 25%, 60%, and 80% of the patients respectively were classified as Ramsay 3 or 4. CONCLUSIONS: Clonidine 100 microg can be indicated as premedication for fasciectomies, being effective in sedation and reduction of intraocular pressure, without adverse effects on blood pressure and heart rate.
Asunto(s)
Analgésicos/administración & dosificación , Extracción de Catarata , Clonidina/administración & dosificación , Medicación Preanestésica , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Justificativa e objetivos:JUSTIFICATIVA E OBJETIVOS: Avaliar a sedação, a pressão intraocular e as alterações hemodinâmicas com o uso de doses baixas de clonidina, 100 µg e 200 µg por via oral, como medicação pré-anestésica para operações de catarata...
Background and objetives: The objective of the present study was to evaluate the degree of sedation, intraocular pressure, and hemodynamic changes with premedication with low doses of oral clonidine, 100 µg and 200 µg, in outpatient cataract ...
Justificativa y objetivos: Evaluar la sedación, la presión intraocular y las alteraciones hemodinámicas con el uso de bajas dosis de clonidina, 100 µg y 200 µg por vía oral, como medicación preanestésica para operaciones de catarata...
Asunto(s)
Humanos , Masculino , Femenino , Clonidina/administración & dosificación , Clonidina/efectos adversos , Presión Intraocular , Extracción de Catarata , Procedimientos Quirúrgicos OftalmológicosRESUMEN
JUSTIFICATIVA E OBJETIVOS: A síndrome de Pallister-Killian (SPK) é uma doença genética rara causada por uma anomalia, em mosaico, no cromossomo 12. Há pouca informação sobre esta síndrome na literatura anestésica. O objetivo deste relato foi divulgar e discutir as características que podem ser de interesse para a anestesia. RELATO DO CASO: Paciente do sexo masculino, 5 anos de idade, foi submetido a anestesia geral para a realização de ressonância magnética do crânio. Apresentava as características típicas da SPK: dismorfismo facial, alopecia temporal, micrognatismo, macroglossia, retardo mental, convulsões e alterações pigmentares cutâneas. A anestesia foi induzida e mantida com sevoflurano sob máscara facial e cânula orofaríngea, com ventilação assistida manual durante a indução. Não houve intercorrências e o exame foi feito em regime ambulatorial. CONCLUSÕES: A importância da avaliação pré-anestésica é enfatizada, devido às malformações, inclusive cardíacas, associadas a esta síndrome. É recomendada a preparação para possível dificuldade de intubação traqueal ou de manutenção das vias aéreas.
Asunto(s)
Humanos , Preescolar , Cromosomas Humanos Par 12 , Isocromosomas , Tetrasomía/patología , Anestesia General/instrumentación , Anestesia/métodosRESUMEN
JUSTIFICATIVA E OBJETIVOS: O remifentanil é o opióide mais recentemente introduzido na prática anestésica. O objetivo desse estudo foi rever a literatura, com ênfase na informação de interesse clínico publicada no período de janeiro de 2000 a dezembro de 2002. CONTEUDO: Os principais estudos sobre remifentanil são descritos e agrupados por áreas de interesse para a anestesia clínica. Aspectos como dose recomendada, equipamento e forma de uso, analgesia de transição e áreas em que o uso ainda é controverso, como para sedação, cirurgia pediátrica, obstétrica e terapia intensiva, são discutidos. CONCLUSÕES: O remifentanil é atualmente o opióide mais adequado para administração por infusão venosa contínua e pode tornar mais eficiente a prática clínica do anestesiologista ao serem seguidas as recomendações para o seu uso.
BACKGROUND AND OBJECTIVES: Remifentanil is the newest opioid for anesthetic procedures. This study aimed at reviewing the literature, with emphasis on information of clinical interest published from January 2000 to December 2002. CONTENTS: Major remifentanil studies are described and grouped by areas of interest for clinical anesthesia. Issues such as recommended dose, equipment and their correct use, transitional analgesia, as well as controversial indications, such as sedation, pediatric or obstetric surgery and intensive care, are discussed. CONCLUSIONS: Remifentanil is currently the best opioid for continuous intravenous infusion and may improve anesthesiologist's efficiency provided usage recommendations are followed.
JUSTIFICATIVA Y OBJETIVOS: El remifentanil es el opioide más recientemente introducido en la práctica anestésica. El objetivo de ese estudio fue rever la literatura, con énfasis en la información de interés clínico publicada en el período de enero de 2000 a diciembre de 2002. CONTENIDO: Los principales estudios sobre remifentanil son descritos y agrupados por áreas de interés para la anestesia clínica. Aspectos como dosis recomendada, equipamiento y forma de uso, analgesia de transición y áreas en que el uso aún es controvertido, como para sedación, cirugía pediátrica, obstétrica y terapia intensiva, son discutidos. CONCLUSIONES: El remifentanil es actualmente el opioide más adecuado para la administración por infusión venosa continua y puede hacer más eficiente la práctica clínica del anestesista a partir del momento en que sean seguidas las recomendaciones para su uso.
Asunto(s)
Analgésicos Opioides , Anestesia/métodosRESUMEN
BACKGROUND AND OBJECTIVES: Remifentanil is the newest opioid for anesthetic procedures. This study aimed at reviewing the literature, with emphasis on information of clinical interest published from January 2000 to December 2002. CONTENTS: Major remifentanil studies are described and grouped by areas of interest for clinical anesthesia. Issues such as recommended dose, equipment and their correct use, transitional analgesia, as well as controversial indications, such as sedation, pediatric or obstetric surgery and intensive care, are discussed. CONCLUSIONS: Remifentanil is currently the best opioid for continuous intravenous infusion and may improve anesthesiologist's efficiency provided usage recommendations are followed.
RESUMEN
BACKGROUND AND OBJECTIVES: Pallister-Killian Syndrome (PKS) is a rare genetic disease due to a mosaic anomaly of chromosome 12. There is little information about PKS in the anesthetic literature. This report aimed at discussing aspects of this syndrome that may be relevant to anesthesia. CASE REPORT: A 5-year-old male patient with typical PKS characteristics (facial dimorphism, temporal alopecia, micrognathia, macroglossia, mental retardation, seizures and pigmentary skin lesions) was scheduled to magnetic resonance of the head under general anesthesia. He was induced and maintained with sevoflurane under facial mask and oropharyngeal canulla. Pulmonary ventilation was manually assisted during induction. There has been no complication and the procedure was performed in outpatient regimen. CONCLUSIONS: The importance of a thorough preanesthetic evaluation is emphasized due to possible malformations associated to PKS, including cardiopathies. Attention to difficult intubation or maintenance of the airways is recommended.
RESUMEN
As alteraçöes histológicas de oito casos de meduloblastoma desmoplásico säo investigadas e comparadas às do meduloblastoma clássico. As neoplasias histologicamente menos malígnas foram as do grupo do meduloblastoma desmoplásico, caracterizadas por menor frequência de necrose, menor índice mitótico e alteraçöes nucleares leves