999 resultados para anestesia geral


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BACKGROUND. This study aimed to evaluate clinical characteristics of epidural anesthesia performed with 0.75% ropivacaine associated with dexmedetomidine. METHODS. Forty patients scheduled for hernia repair or varicose vein surgeries under epidural anesthesia participated in this study. They were assigned to: Control Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg); and Dexmedetomidine Group (n = 20), 0.75% ropivacaine, 20 ml (150 mg), plus dexmedetomidine, 1 μg.kg -1. The following variables were studied: total analgesic block onset time, upper level of analgesia, analgesic and motor block duration time, intensity of motor block, state of consciousness, hemodynamics, postoperative analgesia and incidence of side-effects. RESULTS. Epidural dexmedetomidine did not affect onset time or upper level of anesthesia (p > 0.05) however it prolonged sensory and motor block duration time (p < 0.05) and postoperative analgesia (p < 0.05), and also resulted in a more intense motor block, 1 (p < 0.05). Values of bispectral index were lower in Dexmedetomidine Group (p < 0.05). There was no difference in incidence of hypotension and bradycardia (p > 0.05). Occurrence of side-effects (shivering, vomiting and SpO 2 < 90%) was low and similar between groups (p > 0.05). CONCLUSION. There is clear synergism between epidural dexmedetomidine and ropivacaine, further this drug association does not bring about additional morbidity.

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The basalts of the Formação Serra Geral in Parana Basin in the Mato Grosso do Sul and Mato Grosso states cover an area of 180,000 km2. They rest on the Botucatu sandstones and they are recovered by the sedimentary rocks of Bauru and Caiuá Groups. The mineralogical composition of these rocks are plagioclase (40%-55%), clinopyroxenes (19%-40%; augite and pigeonite), opaque minerals (2%-10%; magnetite and ilmenite) and olivine (1.5%). Geochemical data show two different types of basalts, named ATi-Pitanga (2.6% < TiO2 < 4.2%; 396 ppm < Sr < 438 ppm) and BTi-Ribeira (1.7% TiO2 <2.4%, 246 ppm < Sr < 286 ppm). In general, ATi-Pitanga have gently higher La/Yb(n) (6,1 ± 1,5ppm) than those BTi-Ribeira (5.6 ± 1,7ppm). The geochemical differences between ATi-Pitanga and BTi-Ribeira probably are related to different degrees of partial melt of a same mantle source, or to different mantle sources. The field relations show that BTi-Ribeira is displaced towards the north-western margin of the Paraná Basin and the thickness of lava flows increases towards the Paraná Graben, suggesting that ATi-Pitaga overlies BTi-Ribeira.

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Introduction: Needle infi ltration of local anesthetic is a painful procedure, thus, a topical anesthetic is a comfortable alternative; however, it is diffi cult to deliver transcutaneous polar drugs. Iontophoresis is a noninvasive technique that uses electrical current for releasing electrically charged drugs through biological membranes. Objective: To evaluate the anesthesia induced by iontophoresis of lidocaine for a standardized painful stimulus. Material and methods: Randomized, controlled, double-blind study, involving 10 volunteers under the anesthetic effects of topical application of lidocaine gel 2% and noradrenaline 1:50,000, with or without iontophoresis of 1.85 milliamps for 13 minutes. Pain sensitivity was evaluated by the prick of a 21G needle in the arms posterior region, using a visual numerical scale. Results: Patients mean age was 50.8 ± 11.4 years. Nine of them were women. All had previously received infi ltrative anesthesia. Iontophoresis was well tolerated by volunteers. The median pain scores were 0 and 3 for the arm that received the iontophoresis and for the one that did not receive, respectively (p < 0.01). Conclusion: The anesthetic effect in the region subjected to iontophoresis suggests an effi cient and comfortable method for promoting local anesthesia in the surgical approach of pediatric, hyperalgic, or needlephobic patients.

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BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.

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The analyses of Guimarães Rosa's works often consider relevant facts connected to the author's personal life: his childwood in Sertão of Minas Gerais and his posterior wanderings through this region, his medical and diplomatic career, his deep knowledge of several languages, his misticism. His literary work would be a quite faithful reflection of his life. In this work, an analysis of Campo Geral (1956) [1977], considered by many critics as an autobiographical novel, is proposed, aiming to conciliate the inevitable influence of the author's biographical life without confounding or mixing enunciation scene with historical situation. Therefore, it was taken into account concepts of scenography, paratopia and of person-writer-inscriber, as proposed by Maingueneau (2006).

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

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Pós-graduação em Biologia Geral e Aplicada - IBB

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Pós-graduação em Ciências Sociais - FFC

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)