Evidence-based recommendations for obstetric anesthesia in patients with unruptured intracranial aneurysm are lacking. Experimental or clinical data confirming or refuting general anesthesia or regional blocks in this context do not exist. Thus, the decision of which technique should be used is individual, considering the risks and benefits of each procedure and the experience of the anesthesiologist.

No abstract

Coagulopathy in surgical patients can cause perioperative complications, as both bleeding and thromboembolic events increase surgical morbimortality. The recognition of preexisting disorders and the understanding of the dynamic changes in hemostasis during surgery are prerequisites of safe patient management. The perioperative management of patients with chronic kidney failure is a huge challenge due to both the hypercoagulable state and increased risk of bleeding. Classic laboratory exams performed for the evaluation of blood clotting seem insufficient regarding the determination of the risk of bleeding and thrombosis in surgical patients. As patients with chronic kidney failure develop secondary hyperparathyroidism, the aim of the present study was to describe a case series and correlate the perioperative thromboelastographic profile of patients with chronic kidney failure submitted to parathyroidectomy with their secondary hyperparathyroidism.

A single dose of hypertonic isoncotic saline solution [7.2% NaCl/6% HES (200/0.5)] and mannitol (20%) with equivalent osmolar loads were effective and safe in producing cerebral relaxation during elective neurosurgical procedures under general anesthesia.

No abstract

The initial data show that remifentanil is a promising option to be employed in situations where the parturient cannot or does not want to receive the neuraxial analgesia.

A monitorização perioperatória da coagulação sanguínea é crítica para entender melhor as causas de hemorragia, guiar terapias hemostáticas e prever o risco de sangramento durante procedimento cirúrgico. Nosso entendimento de coagulopatia perioperatória, ferramentas diagnósticas e abordagens terapêuticas têm evoluído nos últimos anos. O recentemente desenvolvido modelo celular da coagulação somado aos novos testes hemostáticos viscoelásticos (TEG e ROTEM) e testes de função plaquetária realizados à beira do leito facilita o entendimento e mede a formação e resolução do coágulo no sangue total, possibilitando rápido diagnóstico e tratamento da coagulopatia perioperatória.

Background and objectives:Cerebral relaxation during intracranial surgery is necessary, and hiperosmolar therapy is one of the measures used to this end. Frequently, neurosurgical patients have sodium imbalances. The objective of the present study was to quantify and determine cerebral relaxation and duration of hydroelectrolytic changes secondary to the use of mannitol versus hypertonic isoncotic solution (HIS) during neurosurgery.