Increased markers in Group I (M5) suggests an increase in anaerobic metabolism (AM) in the splanchnic circulation while the highest values seen in Group II (GII > GI in M5, p<0.05%) suggest interference of another factor (deep anesthesia) responsible for the increase in AM, probably as a result of increased autonomic nervous system depression and minor splanchnic self-regulation.

The advent of new infusion pumps with pharmacokinetic models of remifentanil, sufentanil and propofol opens a new chapter in TIVA and aligns Brazil with the world tendency in TCI. Those systems will allow TCI of hypnotics and opioids concomitantly. However, the most important conclusion refers to the economy, since drugs used in those pumps will not be restricted to only one drug company, similar to what happened with propofol. Nowadays, TCI devices for the use of propofol and opioids, which accept any pharmaceutical presentation, with the advantage of changing the concentration of the drug in the syringe according to the dilution desired are available.

Remifentanil administered two minutes before induction with propofol did not offer additional cardiovascular protection to tracheal intubation. This suggests that it is not necessary to start the infusion of remifentanil two minutes before anesthetic induction.

The attitude regarding TIVA was predominantly positive. There was no consensus on the influence of the level of knowledge, of the infusion pumps, and of the costs on the use of TIVA.

Total intravenous anesthesia for ablation of AF can be a safe option considering the lack of electrophysiological changes in accessory pathways. The literature on this subject is scarce and new publications could justify, or not, this type of anesthesia during ablation of AF.

No abstract

(Rev Bras Anestesiol, 2004;54:650-662) Senhora Editora, Foi com grande interesse e satisfação que li o artigo referido e publicado em nossa prestigiosa revista. Gostaria de parabenizar os autores pela iniciativa invejável de realizar um estudo interessante e inédito em nosso meio, como este. Preocupado com alguns aspectos conceituais me ocorreu tecer algumas considerações:

No abstract