Avaliação da analgesia visceral e da segurança da infusão contínua da hioscina em equinos

Pós-graduação em Cirurgia Veterinária - FCAV

Clinical evaluation of postoperative sensitivity using self-etching adhesives containing glutaraldehyde

The present clinical study aimed to assess the postoperative sensitivity (POS) after 48 hours and seven days in occlusal restorations bonded with three different adhesive systems, two of them containing glutaraldehyde. The restorative procedures were performed using the three-step etch-and-rinse Adper SBMP-Plus adhesive (SBMP), the two-step etch-and-rinse Gluma Comfort One Bond + Desensitizer adhesive (GC+D) and the all-in-one self-etching/priming I Bond (IB) adhesive, which also has glutaraldehyde in its formula. All cavities were restored with Filtek Supreme nanoparticle composite resin. After 48 hours and seven days the patients were recalled and the postoperative sensitivity evaluated. The data analyzed by non-parametric Friedman test showed no significant differences in POS among the three tested groups after 48 hours and seven days.

Farmacologia clínica da metadona peridural e intravenosa em cães

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

O que os pediatras conhecem sobre avaliação e tratamento da dor no recém-nascido?

OBJETIVO: analisar os conhecimentos dos pediatras que atuam com pacientes neonatais em relação à avaliação e o tratamento da dor do recém-nascido. MÉTODOS: estudo transversal com 104 pediatras (de um total de 110) que trabalhavam em 1999 a 2001, nas sete unidades de terapia intensiva e nos 14 berçários da cidade de Belém, e responderam a um questionário escrito com perguntas a respeito do seu perfil demográfico e do conhecimento de métodos de avaliação e de tratamento da dor no recém-nascido. RESULTADOS: cem por cento dos médicos referiram acreditar que o recém-nascido sente dor, mas apenas um terço deles conhecia alguma escala para avaliar a dor nessa faixa etária. A maioria dos entrevistados referia perceber a presença de dor no recém-nascido por meio de parâmetros comportamentais. O choro foi o preferido para avaliar a dor do bebê a termo; a mímica facial para o prematuro, e a freqüência cardíaca para o neonato em ventilação mecânica. Menos de 10% dos entrevistados diziam usar analgesia para punções venosas e capilares; 30 a 40% referiam empregar analgesia para punções lombares, dissecações venosas, drenagens de tórax e ventilação mecânica. Menos da metade dos entrevistados referiu aplicar medidas para o alívio da dor no pós-operatório de cirurgia abdominal em neonatos. O opióide foi o medicamento mais citado para a analgesia (60%), seguido pelo midazolam (30%). CONCLUSÃO: os pediatras demonstraram pouco conhecimento a respeito dos métodos de avaliação e tratamento da dor no período neonatal. Há necessidade de reciclagens e de atualização no tema para os profissionais de saúde que atuam com recém-nascidos doentes.

Comparação da dor pós-operatória em cães versus gatos após orquiectomia versus ovariohisterectomia

Pós-graduação em Anestesiologia - FMB

Efeitos da dipirona, do meloxicam e da associação dipirona e meloxicam sobre a hemostasia em cães conscientes e sobre o controle da dor pós-operatória em cadelas submetidas à ovariosalpingohisterectomia

Pós-graduação em Cirurgia Veterinária - FCAV

Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery

BackgroundThis is an update of a Cochrane Review first published in The Cochrane Library 2008, Issue 3.Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry compared to no therapy or physiotherapy, including coughing and deep breathing, on all-cause postoperative pulmonary complications andmortality in adult patients admitted to hospital for upper abdominal surgery.ObjectivesOur primary objective was to assess the effect of incentive spirometry (IS), compared to no such therapy or other therapy, on postoperative pulmonary complications and mortality in adults undergoing upper abdominal surgery.Our secondary objectives were to evaluate the effects of IS, compared to no therapy or other therapy, on other postoperative complications, adverse events, and spirometric parameters.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE, EMBASE, and LILACS (from inception to August 2013). There were no language restrictions. The date of the most recent search was 12 August 2013. The original search was performed in June 2006.Selection criteriaWe included randomized controlled trials (RCTs) of IS in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures.Data collection and analysisTwo authors independently assessed trial quality and extracted data.Main resultsWe included 12 studies with a total of 1834 participants in this updated review. The methodological quality of the included studies was difficult to assess as it was poorly reported, so the predominant classification of bias was 'unclear'; the studies did not report on compliance with the prescribed therapy. We were able to include data from only 1160 patients in the meta-analysis. Four trials (152 patients) compared the effects of IS with no respiratory treatment. We found no statistically significant difference between the participants receiving IS and those who had no respiratory treatment for clinical complications (relative risk (RR) 0.59, 95% confidence interval (CI) 0.30 to 1.18). Two trials (194 patients) IS compared incentive spirometry with deep breathing exercises (DBE). We found no statistically significant differences between the participants receiving IS and those receiving DBE in the meta-analysis for respiratory failure (RR 0.67, 95% CI 0.04 to 10.50). Two trials (946 patients) compared IS with other chest physiotherapy. We found no statistically significant differences between the participants receiving IS compared to those receiving physiotherapy in the risk of developing a pulmonary condition or the type of complication. There was no evidence that IS is effective in the prevention of pulmonary complications.Authors' conclusionsThere is low quality evidence regarding the lack of effectiveness of incentive spirometry for prevention of postoperative pulmonary complications in patients after upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large RCTs with high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.

Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Desenvolvimento, validação e confiabilidade de uma escala de dor aguda pós-operatória em bovinos

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

Tumescent local anesthesia with ropivacaine in different concentrations in bitches undergoing mastectomy: plasma concentration and post-operative analgesia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cuidados essenciais e muitas vezes negligenciados na hospitalização de pequenos animais: nutrição e analgesia

The benefits of proper nutrition and analgesia are closely linked when it comes to animals that are suffering from any illness and are hospitalized. In patients who are ill or under the stress of hospitalization, increase secretion of glucagon, catecholamines, cortisol and growth hormone antagonize the effects of insulin, leading to hyperglycemia and degradation of tissue proteins to provide substrate for gluconeogenesis. These changes result in loss of lean body mass, reflecting negatively on tissue repair processes, immune response and prognosis. Likewise, the pain induced by noxious stimulation can lead to protein catabolism, stress, immunosupression, delayed wound healing and acceleration of disease processes. This review confirms the nutrition and pain control importance in hospitalized patients, showing their physiological benefits and reduction in hospital stay when the clinician understands these benefits and the animals are treated with such care

Uso da morfina na analgesia de equinos

Pain control is an important aspect of equine medicine. Musculoskeletal and gastrointestinal diseases are the most important clinical and surgical painful situations in this specie. In these cases, opioids have been used successfully for the treatment of pain, administered both local (intra-articular and epidural) and systemically. Otherwise, opioids, specially mu agonists like morphine, present important side effects in horses. Amongst these effects, CNS stimulation with increased motor activity and impairment of intestinal motility are observed in several cases. Therefore, adequate dosing of administration are essential for the safe use of opioids in horses

Alternative approach to the management of postoperative pain after pediatric surgical procedures

This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children.

Dipirona versus paracetamol no controle da dor pós-operatória

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)