Imobilidade: uma ação essencial dos anestésicos inalatórios

Duarte, Leonardo Teixeira Domingues; Saraiva, Renato Ângelo

doi:10.1590/s0034-70942005000100013

Cited by 4 publications

(5 citation statements)

References 74 publications

(253 reference statements)

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“…This could explain why 49% of patients with adequate MAC had deep BIS values. In clinical practice, a number of factors encourage anesthesiologists to use high MAC values, such as intraoperative recall, good surgical conditions, and fewer dose adjustments 2…”

Section: Discussionmentioning

confidence: 99%

“…Its reliability has been questioned due to its changes with physiological variables, pathologies, and barometric pressure 1. In addition, MAC describes the inhibition of movement response to noxious stimulation 2. Anesthetic overdose with MAC-guided anesthesia is not uncommon and can result in increased risk of complications such as prolonged recovery time, upper respiratory obstruction, post-operative delirium, length of stay, and nausea or vomiting, especially in patients with fragility 3.…”

Section: Introductionmentioning

confidence: 99%

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Frequency of anesthetic overdose with mean alveolar concentration-guided anesthesia at high altitude

2018

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This study reported the frequency of anesthetic overdose measured with the bispectral index in a high altitude city (Bogotá-Colombia, 2600 meters above sea level). We assembled a prospective cohort of patients. Preoperative variables were described, and 10 minutes after the surgical incision, bispectral index, mean alveolar concentration, mean arterial pressure, and oxygen saturation were recorded. Bispectral index was classified as superficial (60), adequate (40–60), and deep (> 40). Mean alveolar concentration was classified as low (< 0.8), normal (0.8–1.2), and high (> 1.2). We included 50 patients. The mean age of the patients was 36.3 ± 13.5 years; 48% were male and 78% were categorized as ASA I. Mean values of mean alveolar concentration and bispectral index were 1.14 ± 0.18 and 38.66 ± 6.9, respectively. Frequency of anesthetic overdose measured with bispectral index was 54% and only 20% with mean alveolar concentration. In total, 78% of patients received normal mean alveolar concentration values, and among these patients, 49% had deep bispectral index levels and 51% were adequate. There was no correlation between mean alveolar concentration and bispectral index (Pearson r = 0.161, P = 0.246) or between bispectral index and mean arterial pressure (Pearson r = 0.367, P = 0.08). All patients older than 60 years exhibited deep bispectral index levels, and although we did not identify a correlation between age and bispectral index, a tendency was observed (Pearson r = –0.087, P = 0.538). Safe and effective anesthesia overdose could be a common phenomenon. Bispectral index-guided anesthesia could be a helpful and reliable tool in the assessment and prevention of anesthesia overdose at high altitude. The study was approved by the ethics committee of the Fundación Cardioinfantil-Instituto de cardiología, Bogota, Colombia (approved number: 312017).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frequency of anesthetic overdose with mean alveolar concentration-guided anesthesia at high altitude

2018

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“…AMPA, NMDA, glycine and GABA A receptors are reportedly involved in the overall anesthetic effect, 28,29 but other receptors and channels may also be relevant. It has been shown that enflurane at 1 MAC depressed synaptic currents in SCMN.…”

Section: Discussionmentioning

confidence: 99%

Isoflurane, but Not the Nonimmobilizers F6 and F8, Inhibits Rat Spinal Cord Motor Neuron CaV1 Calcium Currents

Recio-Pinto

Montoya-Gacharna²,

Xu³

et al. 2016

Anesthesia &Amp; Analgesia

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Background Volatile anesthetics decrease Ca2+ entry through voltage-dependent Ca2+ channels. Ca2+ influences neurotransmitter release and neuronal excitability. Because volatile anesthetics act specifically on the spinal cord to produce immobility, we examined the effect of isoflurane and the nonimmobilizers F6 (1, 2- dichlorohexafluorocyclobutane) and F8 (2, 3- dichlorooctafluorobutane) on CaV1 and CaV2 Ca2+ channels in spinal cord motor neurons and dorsal root ganglion neurons. Methods Using patch clamping, we compared the effects of isoflurane with those of F6 and F8 on CaV1 and CaV2 channels in isolated, cultured adult rat spinal cord motor neurons and on CaV1 and CaV2 channels in adult rat dorsal root ganglion sensory neurons. Results In spinal cord motor neurons, isoflurane, but not F6 or F8, inhibited currents through CaV1 channels. Isoflurane and at least one of the nonimmobilizers inhibited currents through CaV1 and CaV2 channels in dorsal root ganglion neurons and Cav2 in spinal cord motor neurons Conclusion The findings that isoflurane, but not nonimmobilizers, inhibited CaV1 Ca2+ channels in spinal cord motor neurons are consistent with the notion that spinal cord motor neurons might mediate isoflurane-induced immobility. Additional studies are required to examine whether inhibition of CaV1 calcium currents in spinal cord motor neurons are sufficient, or whether actions on other channels/proteins also contribute to isoflurane-induced immobility.

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“…The increase in circulatory catecholamine is responsible for electrolytic, hemodynamic, and neuroendocrine changes (Desborough, 2005). Most anaesthetic drugs do not eliminate the neuronal processes involved with pain (Duarte and Saraiva, 2005), thus, opioid pre-emptive analgesia can play an important role in preventing central sensitization (Wordliczek et al, 2002) and reduce the magnitude and duration of post-operative pain.…”

Section: Introductionmentioning

confidence: 99%

Pre-emptive methadone or tramadol analgesia for mastectomy and ovariohysterectomy in bitches

Uscategui

Tiosso

Moro

et al. 2017

Rev Colomb Cienc Pecu

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Analgesia preventiva con tramadol o metadona para mastectomia y ovario histerectomía en perrasAnalgesia preventiva com tramadol ou metadona para mastectomia e ováriohisterectomia em cadelas Abstract Background: mastectomy and ovariohysterectomy (OVH) in bitches are critical surgeries and pain control can be challenging. Objective: to evaluate the efficacy of pre-emptive analgesia with methadone (MET) or tramadol (TRA) in postoperative pain intensity, cardiorespiratory effects, and anaesthetic/analgesic consumption in female dogs undergoing mastectomy and OVH. Methods: a prospective randomized blind clinical trial was used to evaluate 48 bitches of various breeds, aged 10 ± 3.7 years, weighing 16 ± 12 Kg, and with multiple mammary tumours. The animals were distributed in two groups: TRA group received 5 mg/Kg tramadol and MET group 0.5 mg/Kg methadone intramuscularly, 10 min prior to anaesthesia induction with propofol followed by maintenance with isoflurane. Heart (HR) and respiratory (RR) rates, mean arterial pressure (MAP), propofol induction dose (PID), oxyhemoglobin saturation (SpO 2 ), end-tidal isoflurane concentration (EtISO), and carbon dioxide pressure (EtCO 2 ) were measured during the intra-operative period. Post-operative pain was evaluated for 12 h and rated according to the Melbourne scale. Rescue analgesia (0.5 mg/Kg methadone, 2 mg/Kg lidocaine, or 0.01 mg/Kg/min ketamine IV) was given when necessary and post-operative analgesic consumption recorded. Statistical tests were used to compare treatments. Results: rescue analgesia requirements, pain score, PID and analgesic consumption were significantly lower (p<0.05) in MET group. The HR was higher in TRA group, while EtCO 2 and MAP were higher in MET group (p<0.05). Conclusion: methadone was more effective than tramadol in pre-emptive analgesia but not completely adequate on controlling pain in bitches subjected to

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Imobilidade: uma ação essencial dos anestésicos inalatórios

Abstract: RESUMO

Cited by 4 publications

References 74 publications

Frequency of anesthetic overdose with mean alveolar concentration-guided anesthesia at high altitude

Frequency of anesthetic overdose with mean alveolar concentration-guided anesthesia at high altitude

Isoflurane, but Not the Nonimmobilizers F6 and F8, Inhibits Rat Spinal Cord Motor Neuron CaV1 Calcium Currents

Pre-emptive methadone or tramadol analgesia for mastectomy and ovariohysterectomy in bitches

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