961 resultados para Obstetric analgesia
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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ObjectiveTo compare cardiac output (CO) measured by Doppler echocardiography and thermodilution techniques in spontaneously breathing dogs during continuous infusion of propofol. To do so, CO was obtained using the thermodilution method (CO(TD)) and Doppler evaluation of pulmonary flow (CO(DP)) and aortic flow (CO(DA)).Study designProspective cohort study.AnimalsEight adult dogs weighing 8.3 +/- 2.0 kg.MethodsPropofol was used for induction (7.5 +/- 1.9 mg kg-1 IV) followed by a continuous rate infusion at 0.7 mg kg-1 minute-1. The animals were positioned in left lateral recumbency on an echocardiography table that allowed for positioning of the transducer at the 3rd and 5th intercostal spaces of the left hemithorax for Doppler evaluation of pulmonary and aortic valves, respectively. CO(DP) and CO(DA) were calculated from pulmonary and aortic velocity spectra, respectively. A pulmonary artery catheter was inserted via the jugular vein and positioned inside the lumen of the pulmonary artery in order to evaluate CO(TD). The first measurement of CO(TD), CO(DP) and CO(DA) was performed 30 minutes after beginning continuous infusion (T0) and then at 15-minute intervals (T15, T30, T45 and T60). Numeric data were submitted to two-way anova for repeated measurements, Pearson's correlation coefficient and Bland & Altman analysis. Data are presented as mean +/- SD.ResultsAt T0, CO(TD) was lower than CO(DA). CO(DA) was higher than CO(TD) and CO(DP) at T30, T45 and T60. The difference between the CO(TD) and CO(DP), when all data were included, was -0.04 +/- 0.22 L minute-1 and Pearson's correlation coefficient (r) was 0.86. The difference between the CO(TD) and CO(DA) was -0.87 +/- 0.54 L minute-1 and r = 0.69. For CO(TD) and CO(DP), the difference was -0.82 +/- 0.59 L minute-1 and r = 0.61.ConclusionDoppler evaluation of pulmonary flow was a clinically acceptable method for assessing the CO in propofol-anesthetized dogs.
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Obejective To study the echocardiographic effects of isoflurane at an end-tidal concentration approximating 1.0 times the minimum alveolar concentration (MAC) in healthy unpremedicated dogs.Study design Prospective experimental trial.Animals Sixteen mature mongrel dogs of either sex weighing 11.06 +/- 2.72 kg.Methods After performing a baseline echocardiogram in the awake animal, anesthesia was induced with increasing inspired concentrations of isoflurane via a face mask until tracheal intubation was possible. Following intubation, the end-tidal concentration was decreased to 1.4% for the rest of the anesthetic period. Serial echocardiograms were recorded at 25, 40, and 55 minutes after the end-tidal concentration was reached.Results No changes were observed in heart rate. However, significant decreases were seen in left ventricular end-diastolic diameter (Mean maximal change: 13.8%), interventricular septal thickness during systole (15.2%), interventricular septal thickening fraction (72.2%), left ventricular free wall thickening fraction (63.5%), ejection fraction (39.9%), and fractional shortening (46.7%). In addition, peak flow velocities across mitral, pulmonic, and aortic valves were significantly lower than baseline values. Decreases were also observed in end-diastolic left ventricular volume index (approximately 32.1% from the awake value), stroke index (58.2%), and cardiac index (55.3%) when compared with awake measurements.Conclusions Our results indicate that 1 x MAC isoflurane caused significant myocardial depression in healthy dogs. These changes in myocardial function need to be considered carefully when isoflurane is to be used in dogs with poor cardiovascular reserve.
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Objective-To evaluate analgesic effects of epidurally administered neostigmine alone or in combination with morphine in dogs after ovariohysterectomy.Animals-40 healthy bitches.Procedures-After acepromazine premedication, anesthesia was induced. Dogs randomly received 1 of the following 4 epidural treatments 30 minutes before ovariohysterectomy (n = 10/group): saline (0.9% NaCl) solution (control), morphine (0.1 mg/kg), neostigmine (10 pg/kg), or morphine-neostigmine (0.1 mg/kg and 10 pg/kg, respectively). Analgesia was assessed for 24 hours after surgery by use of a visual analogue.scale (VAS; scale of 0 to 10) or numeric descriptive scale (NDS; scale of 0 to 24) and by the need for supplemental analgesia (morphine [0.5 mg/kg, IM] administered when VAS was >= 4 or NDS was >= 8).Results-Significantly more control dogs (n = 8) received supplemental analgesia, compared with the number of neostigmine-treated dogs (1); no dogs in the remaining groups received supplemental analgesia. Compared with values for the control dogs, the NDS scores were lower for morphine-neostigmine-treated dogs (from 2 to 6 hours and at 12 hours) and for morphine-treated dogs (all time points). The NDS scores were lower for morphine-treated dogs at 3, 12, and 24 hours, compared with values for neostigmine-treated dogs. The VAS was less sensitive than the NDS for detecting differences among groups.Conclusions and Clinical Relevance-Epidurally administered neostigmine reduced the use of supplemental analgesia after ovariohysterectorny in dogs. However, analgesic effects were less pronounced than for epidurally administered morphine or morphine-neostigmine. Adding neostigmine to epidurally administered morphine did not potentiate opioid-induced analgesia.
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Objective To establish the correlation between the bispectral index (BIS) and different rates of infusion of propofol in dogs.Study design Prospective experimental trial.Animals Eight adult dogs weighing 6-20 kg.Methods Eight animals underwent three treatments at intervals of 20 days. Propofol was used for induction of anesthesia (10 mg kg(-1) IV), followed by a continuous rate infusion (CRI) at 0.2 mg kg(-1) minute(-1) (P2), 0.4 mg kg(-1) minute(-1) (P4) or 0.8 mg kg(-1) minute(-1) (P8) for 55 minutes. The BIS values were measured at 10, 20, 30, 40, and 50 minutes (T10, T20, T30, T40, and T50, respectively) after the CRI of propofol was started. Numeric data were submitted to analysis of variance followed by Tukey test (p < 0.05).Results The BIS differed significantly among groups at T40, when P8 was lower than P2 and P4. At T50, P8 was lower than P2. The electromyographic activity (EMG) in P2 and P4 was higher than P8 at T40 and T50.Conclusion An increase in propofol infusion rates decreases the BIS values and EMG.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Objective To examine the anesthetic effects of a xylazine-diazepam-ketamine (XDK) combination in roosters.Study design Prospective experimental trial.Animals Six healthy white Leghorn roosters weighing 2.03 +/- 0.08 kg.Methods Each rooster was pre-medicated with xylazine (3 mg kg(-1), IM) and after 15 minutes anesthesia was induced with a diazepam (4 mg kg(-1)) and ketamine (25 mg kg(-1)) combination injected into the pectoral muscles. Heart and respiratory rates were recorded before anesthesia and every 15 minutes after induction for 165 minutes. Cloacal temperature was measured before and 15 minutes after pre-medication and every 75 minutes thereafter during anesthesia. Quality of induction and recovery were scored subjectively; duration of loss of righting reflex, abolition of response to a painful stimulus and palpebral reflex were also recorded.Results Intramuscular injection of xylazine smoothly induced loss of the righting reflex within 3-4 minutes. Loss of response to a painful stimulus occurred at 13.1 +/- 2.9 minutes (mean +/- SD) after the administration of the D-K combination, and lasted for 63.0 +/- 5.3 minutes. Roosters anesthetized with this combination had a significant decrease in heart and respiratory rates and cloacal temperature. The recovery period lasted for up to 4 hours (227.5 +/- 15.4 minutes). Quality of recovery was satisfactory for four roosters but excitation was noted in two birds.Conclusions and clinical relevance The XDK combination was a useful anesthetic technique for typhlectomy in roosters. Nevertheless this drug combination should be used with caution and cardiopulmonary parameters monitored carefully. Under the conditions of this experiment it was associated with a decreased cloacal temperature and prolonged recoveries.
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After the birth of a child, during the post-partum period, the exercise of fatherhood, the sexual relationships either marital or sexual as well as the definition of the male role are all aspects that can change. These changes are guarded and can contribute to strengthen the familiar bond or deprive it. Thus, this study aims to understand the male experience during the partner s puerperal period. In this period, the male interacts and participates according to his understanding of the post-partum period. The male experiences different situations with his partner, family and social environment. This research is descriptive-exploratory and has a qualitative approach. It was developed with 15 men that live with their live with their partners during the puerperal period. The data was collected through a semi-structured interview. These data was treated according to content analysis proposed by Bardin. These were analyzed through Symbolic Interacionism according to Blumer. Thus, three themes emergedshares of care in the home environment, meanings attributed to the puerperium, emotions emerged during the post-partum - the seven subcategories-taking care of the wife and child, supporting the family, moment to rest, fulfillment through fatherhood, sense of joy, feeling of concern and sense of exclusion. It was seen that the subjects experience post-partum mainly by taking care of their partner and child and providing support of the family. Besides the mentioned aspects, there was meaning attributed to the puerperal period, considering it a period of rest for the partner and above all, fatherhood. Thus, even understanding that it is excluded, the subjects expressed joy and worriness towards the child s future, related to the insecurity in which the country goes through in current conjuncture
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The consultation for women during the postpartum period should occur between the seventh and tenth days, and 42 days after childbirth, to decrease the incidence of maternal and neonatal morbidity and mortality. However, the effectiveness of such assistance in primary health care has not been achieved, especially in the forty-second day of puerperium. Facing this reality, the research aimed to understand the views of women about postpartum consultation. This is an exploratory and descriptive research with qualitative approach, developed in the municipality of Lajes/RN, Brazil, with women inscribed on the four teams that make up the Family Health Strategy. Data were collected through semistructured interviews with 15 women who met the following criteria: be enrolled in ESF; have health mental preserved, have been entered in the Humanization Program of Prenatal and Birth, and that was, at maximum, 60 days postpartum. The data were organized according to the precepts of content analysis according to Bardin, generating three categories: prevention of puerperal complications, feelings related to life changes after childbirth, and postpartum care. This process of coding and categorizing a central theme emerged: the experience of women in the postpartum period. The data were analyzed according to the principles of symbolic interactionism, according to Blumer. The study revealed that the meanings attributed to the postpartum period for prevention of complications were directly related to home, to the consultation and postpartum care provided by family members and health professionals. The interviewees strictly complied with the rest under the influence of the context in which they were entered. But that has not happened with the postpartum revision because few mothers underwent this procedure. Therefore, the interaction of the interviewed people in their living standard as well as the feelings that permeated the post-partum were crucial to consider whether or not the post-partum visit as significant. According to the results, it was noted that disability guidelines and counter-references has impaired the access of women to postpartum review. Thus, further studies are needed on the subject, as well as a reorientation of health care activities in view of the consolidation of postpartum consultation in primary care
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The pregnancy as a process in woman's life requires several biological, psychological, relational and socio-cultural changes for the preparation for motherhood. By modifying its capacity and, at the expense of these factors, it is observed that the physical, social and emotional problems experienced by women during pregnancy can affect their quality of life, especially related to health. It had as objectives of this research verifying the quality of life of women in the context of the Family Health Strategy in a municipality in Paraíba, in order to characterize the sociodemographic aspects, lifestyle habits, and obstetric care of pregnant women and to characterize the fields of quality of life of pregnant women according to the WHOQOL-bref. This is a descriptive exploratory study with cross-sectional and quantitative approach. The population consisted of 120 pregnant women in primary care in the municipality of Sousa-PB. Data collection occurred over a period of two months by the own master's degree student and two nursing students in applying a standard form about sociodemographic characteristics, and obstetric care and the WHOQOL-bref instrument. The data collected were organized into an electronic database of the Microsoft Excel application, coded, tabulated and presented in tables, charts and figures with their respective percentage distributions. Of the surveyed, the predominant were age group of 20 to 25 years, Catholic religion, with a steady partner, low education, no employment, wage income of 01 minimum wage. As for the data and obstetric care, almost all had never aborted and reported to the care received as excellent. The most frequent complaints were back pain and in lower abdomen. Regarding quality of life according to the WHOQOL-bref, dissatisfactions that predominated in the areas were in the physical pain and discomfort, sleep, rest, energy and fatigue. In the psychological domain, body image and appearance, memory, concentration and negative feelings. In the field of social relationships, sexual activity and the environment domain, the greatest dissatisfaction with facets scored: financial resources, leisure opportunities and transport. It is concluded that the quality of life of the users interviewed were deemed unsatisfactory for these facets, indicating that assistance to this target audience should be done comprehensively and holistically, in order to accommodate the affected facets to improve the quality of life pregnant women attended in primary care
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The Urinary Tract Infection (UTI) in pregnancy is important as a consequence of the high incidence during the gestation. It is the third most common clinical complication in pregnancy affecting 10-12% of women whether prevalence is increasing in the first trimester of pregnancy, it may also contribute to maternal and infant mortality. Due the relevance for the results of obstetric and neonatal complications from UTI, these complications must be prevented, because it can lead to health hazards to pregnant women and newborns, producing a direct effect on morbidity and perinatal mortality. On this basis, it was defined as objectives of this research the identification of the profile of nurses from the Family Health Strategy (FHS) in the East and West Health Districts from the city of Natal / RN before the women with UTI and to verify the nurse performance during prenatal consultations. This is an exploratory study with a quantitative approach using a sample of 40 nurses active workers during this survey, it was approved by the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte Protocol n0 232/10 P-CEP/UFRN and opinion n0 080/2011. The tool for data collection was a structured interview. The data collected were organized into an electronic database application Microsoft ® Excel 2007, exported and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0, and coded, tabulated and presented through tables and charts into their respective percentage distributions, using the descriptive and inferential statistical analysis, chi-square test and significance level of 5% (distribution in relative and absolute frequencies) in the independent variables. Therefore, it was observed from these results that the longer action of nurses in the FHS from the East and Weast health districts of the city of Natal/RN contributed to the development of a greater number of activities to control the incidence of UTI in women who are attended in the prenatal care service, proven by significance in statistics
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)