Alterações eletroneurofisiológicas em anestesia com sevoflurano: estudo comparativo entre pacientes saudáveis e pacientes com paralisia cerebral

Abstract

RESUMOMello SS, Saraiva RA -Alterações Eletroneurofisiológicas em Anestesia com Sevoflurano: Estudo Comparativo entre Pacientes Saudáveis e Pacientes com Paralisia Cerebral sevoflurane and 60% N 2 O in assisted ventilation. BIS and N9, N13, J u s t i f i c a t i v a e O b j e t i v o s -E s t u d o s a v a l i a n d o a farmacodinâmica de drogas anestésicas em Paralisia Background and Objectives -There are very few studies on anesthetic drugs pharmacodynamics in patients with Cerebral P a l s y ( C P ) . T h i s s t u d y a i m e d a t c o m p a r i n g electroneurophysiological responses in healthy and CP patients, using bispectral index (BIS) and short-latency s o m a t o s e n s o r y e v o k e d p o t e n t i a l ( S E P ) t o m o n i t o r e s e v o f l u r a n e -i n d u c e d c e n t r a l n e r v o u s s y s t e m ( C N S ) electroneurophysiological changes. Methods -Twenty four patients aged 3 to 18 years, scheduled for surgical procedures were allocated in two groups: 1. CP -12 patients with spastic CP; 2. Control (C) -12 patients with no n e u r o l o g i c a l d i s e a s e . A n e s t h e s i a w a s i n d u c e d w i t h

50% effective concentration of sevoflurane for immobility in cerebral palsy children undergoing botulinum toxin injection

“…[10] However, authors did not report the end-tidal sevoflurane concentration. We assumed that the sevoflurane concentration required for botulinum toxin injection would be lower than sevoflurane MAC estimated in children without CP because children with CP have higher sensitivity to sevoflurane [18][19][20] and intramuscular injection using a 25 gauge needle may result in less intensity of stimulation compared with the skin incision. The EC 50 of sevoflurane (1.76%) for successful injection of botulinum toxin in children with CP in the present study is lower than those (approximately 2.03-2.50%) reported in children without CP with similar age ranges for skin incision.…”

Complicações respiratórias em pacientes com paralisia cerebral submetidos à anestesia geral

“…Therefore, textbooks on the subject present a brief discussion, and very often present statements that have not been widely documented or that are based on weak evidence [5][6][7] . The effects of some of the drugs used in anesthesia in patients with CP, such as neuromuscular blockers 8,9 and halogenated compounds [10][11][12] , have already been studied. There are also, in the medical literature, studies on the complications of specific surgical procedures in those patients 13 .…”

“…O risco relativo (RR) foi calculado para os fatores de risco de interesse. Risco relativo é a incidência da complicação em um grupo dividido pela incidência no outro grupo, sendo uma medida usada para expressar a força da associação entre dois eventos, no caso, a variável versus a Vol. [10][11][12] , foram estudados previamente. Trabalhos relacionados com complicações de tipos específicos de procedimentos cirúrgicos nesses pacientes também já foram publicados 13 .…”

Comparação dos valores do índice bispectral em pacientes com paralisia cerebral em estado de vigília

“…There is a report in the literature on the use of EEG-BIS in patients with a diagnosis of CP, but they were under general anesthesia or sedation with oral midazolam 19,20 . Considering that there are no reports on the use of this tool in awake CP patients, its use in children with morphological CNS abnormalities, such as periventricular leucomalacia, could lead to questioning of its reliability, since certain areas could present a deficit in blood flow and neuronal mass.…”