Abstract:
BACKGROUND AND OBJECTIVES:Thoracic epidural blockade is a method of hypotensive anesthesia able to reduce bleeding during surgery. This non-comparative study aimed at evaluating the results of thoracic epidural blockade with 0.5% ropivacaine associated to propofol continuous infusion sedation in plastic surgery. METHODS:Participated in this study 60 female patients aged 18 to 62 years, physical status ASA I or II, scheduled for combined plastic surgeries of breast, abdomen, gluteus and liposuction. After epidural puncture in T9-T10 or T10-T11, patients received 40 ml of 0.5% ropivacaine and 15 microg sufentanil. Additional local anesthetic doses were administered through an epidural catheter, if necessary. Sedation was induced with 40 to 50 microg kg(-1) min(-1) propofol continuous infusion. Blockade installation and regression, hemodynamic and respiratory parameters and the incidence of adverse effects were investigated. RESULTS:Upper sensory block level was T2 in 52 patients (86.6%), C4 in 4 (6.6%), and T3 in 4 (6.6%). Mean onset time was 9.1 +/- 8.2 min. Motor block grade 2 was obtained in 61.7% of patients, and grade 1 in 38.3%. Mean time for complete motor block regression was 377.9 +/- 68.5 min. Mean time for first spontaneous pain complaint was 965.1 +/- 371.3 min. SBP, DBP, MBP and HR mean values have significantly decreased as compared to control as from 15 min after local anesthetic injection, thus characterizing hypotensive anesthesia. Thirteen patients (21.7%) with SBP < 65 mmHg and/or MBP < 50 mmHg received a vasopressor (ethylphedrine) and 4 patients (6.7%) with HR < 50 bpm received atropine. No patient needed blood transfusion. CONCLUSIONS:Thoracic epidural blockade with 0.5% ropivacaine and 15 microg sufentanil associated to propofol continuous infusion sedation is a satisfactory hypotensive anesthesia technique for combined plastic surgeries involving breast, abdomen, gluteus and liposuction. Continuous monitoring of hemodynamic and respiratory parameters as well as controlling blockade effects on those parameters are critical for the success and safety of the technique.
journal_name
Rev Bras Anestesioljournal_title
Revista brasileira de anestesiologiaauthors
Nociti JR,Serzedo PS,Zuccolotto EB,Gonzalez Rsubject
Has Abstractpub_date
2002-04-01 00:00:00pages
156-65issue
2eissn
0034-7094issn
1806-907Xpii
S0034-70942002000200003journal_volume
52pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:Von Willebrand's disease is the most common hereditary coagulation disorder in young women. The incidence of HIV infection among women has been progressively increasing, and vertical transmission may account for 25% of cases. This report aimed at describing the case of an HIV-positive patient ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942004000600006
更新日期:2004-12-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
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doi:10.1590/s0034-70942004000100017
更新日期:2004-02-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
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abstract:BACKGROUND AND OBJECTIVES:The adequate maintenance of inhaled gases temperature during anesthetic procedures is critical to prevent perioperative respiratory complications. This study aimed at comparing the ability to warm up inhaled gases of coaxial breathing system and conventional system, by varying fresh gas flows ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942005000100008
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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更新日期:2003-08-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
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journal_title:Revista brasileira de anestesiologia
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doi:10.1016/j.bjan.2018.11.003
更新日期:2019-01-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
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更新日期:2006-08-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
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更新日期:2010-01-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942008000100003
更新日期:2008-01-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:
更新日期:2004-10-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2019.01.004
更新日期:2019-01-01 00:00:00
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,评审
doi:10.1016/j.bjan.2020.02.004
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journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
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更新日期:2011-09-01 00:00:00