Abscesso do músculo psoas em paciente submetida à analgesia por via peridural. Relato de caso

BACKGROUND AND OBJECTIVES: Psoas muscle abscess is a rare complication of epidural analgesia. The adequate approach to this complication is fundamental for a good resolution. The objective of this report was to discuss the diagnosis and treatment of psoas muscle abscess. CASE REPORT: A female patient, 65 years old, with neuropathic pain in the lower limbs, difficult to control with systemic drugs. The patient was treated with epidural opioid and local anesthetic as an alternate treatment. Twenty days after the continuous epidural administration, the patient complained of lumbar pain, headache, and fever. A CT scan of the pelvis showed an abscess of the psoas muscle, thus, closed drainage and antibiotics were indicated. CONCLUSIONS: An adequate, continuous supervision of the patient is necessary when an epidural catheter is placed, and it should continue after its removal. © Sociedade Brasileira de Anestesiologia, 2007.

Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs

Constant rate infusion (CRI) shows several advantages in balanced anesthesia, such as reduction of requirement for inhaled anesthetics and control of pain. The most commonly used drugs in these protocols are local anesthetics, dissociative, and opioids, which may be administered alone or in combinations. We evaluated the records of 200 dogs that underwent various surgical procedures with anesthetic or analgesic CRI in the perioperative period during 2011 and 2012 at the Veterinary Hospital of Franca University (Unifran), and identified possible complications during the transoperative period. Records evaluated included clinical state, laboratory tests, drugs used in premedication and induction, and CRI protocol. Acepromazine and morphine were the main drugs used in premedication. Propofol was used to induce anesthesia alone or in combination with other agents. We evaluated records of the 25 different CRI protocols. Fentanyl was the main drug employed in CRI, either alone or in combination. There were 128 episodes of anesthetic complications during CRI;the most common were hypotension, hypertension, and tachycardia, which occurred in 43 (32%), 35 (26.3%), and 19 (14.2%) dogs, respectively. Cardiac arrhythmia was reported in only 4 dogs. Signs of respiratory depression were present in dogs treated with 6 different CRI protocols. The consumption of isoflurane (vol %) reduced between 15.7% and 21.05% after 30minutes of the CRI in the fentanyl and fentanyl-lidocaine-ketamine CRI groups (p<0.05). In conclusion, CRI is a valid component of balanced anesthesia in dogs, safe, and has a low incidence of adverse effects. However, future studies are warranted to describe the results of the clinical use of CRI to better characterize and refine this technique.

Comparison of inflammatory cytokine profiles in plasma of patients undergoing otorhinological surgery with propofol or isoflurane anesthesia

Objective and design: The effects of anesthetics on cytokine release in patients without comorbidities who undergo minor surgery are not well defined. We compared inflammatory cytokine profiles in adult patients undergoing minimally invasive surgery who received isoflurane or propofol anesthesia. Methods: Thirty-four patients without comorbidities undergoing minor surgery were randomly assigned to receive an inhaled anesthetic (isoflurane; n = 16) or an intravenous anesthetic (propofol; n = 18). Blood samples were drawn before premedication and anesthesia (T1), 120 min after anesthesia induction (T2), and on the first post-operative day (T3). Plasma concentrations of interleukins (IL-) 1β, 6, 8, 10 and 12 and tumor necrosis factor (TNF)-α were measured using flow cytometry. Results: The pro-inflammatory cytokine IL-6 was increased in the isoflurane group at T2 and T3 compared to T1 (P < 0.01). In the propofol group, IL-6 and IL-8 were significantly increased at T3 compared to T1. However, there were no significant differences in cytokine concentrations between the isoflurane and propofol groups. Conclusion: An inflammatory response occurred earlier in patients who received an inhaled agent compared with an intravenous anesthetic, but no differences in plasma cytokine profiles were evident between isoflurane and propofol anesthesia in patients without comorbidities undergoing minimally invasive surgeries. © 2013 Springer Basel.

Avaliação da eficácia e dos efeitos respiratórios da anestesia peridural torácica em cães

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação de duas doses de lidocaína, administradas à altura da primeira vértebra lombar sobre a analgesia trans-cirúrgica e parâmetros cardiorrespiratórios em cadelas submetidas à ovariohisterectomia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da associação de dexmedetomidina à ropivacaína 0,75% na anestesia peridural

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos da administração peridural de neostigmina associada ou não a clonidina sobre a concentração alveolar mínima do isoflurano em cães

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos analgésicos da neostigmina e morfina, isoladas ou associadas, pela via peridural em cadelas submetidas à ovariosalpingohisterectomia(OSH)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da administração epidural de dexmedetomidina sobre a concentração alveolar mínima do isofluorano em cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Complicações intra-operatórias das anestesias do neuroeixo realizadas de maio de 1990 a maio de 2008 na FMB-UNESP: análise retrospectiva

Pós-graduação em Anestesiologia - FMB

Flebografia epidurla lombossacral em gatos por meio da veia safena lateral

Pós-graduação em Medicina Veterinária - FMVZ

Efeito da alizaprida intravenosa sobre o prurido provocado pela morfina administrada por via subaracnóidea

Pós-graduação em Anestesiologia - FMB

Efeitos da injeção epidural de cetamina ou da sua associação com ifenprodil na mediação nociceptiva somática e visceral em equinos

Pós-graduação em Cirurgia Veterinária - FCAV

Ultrassonografia do espaço intervertebral lombossacro em cães

Pós-graduação em Cirurgia Veterinária - FCAV

Morfina em diferentes doses associadas à levobupivacaína ou à ropivacaína pela via peridural em cadelas para realização de ovariossalpingohisterectomia eletiva

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)