Pedro Kimachi | Instituto de Ensino e Pesquisa Hospital Sírio Libanes (original) (raw)
Papers by Pedro Kimachi
E-Poster Viewing Abstracts, 2019
Background and aims Treatment crises are frequent in the elderly population, usually with comorbi... more Background and aims Treatment crises are frequent in the elderly population, usually with comorbidities that may prolong the hospitalization of these patients. The great interest is a quick recovery, but with an efficient analgesia that allows an early mobilization of the patients. Methods Case report Results Patient is 91 years old, ASA II, who is presenting with left transtrocantical fracture, discrete mental and previous history of abdominal distension and nausea with the use of PCA morphine. The association was associated with blockage of the supinguinguinal iliac fascia associated with the PENG block before surgery, avoiding hemodynamic repercussions of the neuraxis, but maintaining the benefits and discussed regional anesthesia. 20 ml of lidocaine 2% + 4 mg of dexamethasone without iliac fascia and 20 ml of ropivacaine 0.375% + 6 mg dexamethasone were used in the PENG block, both of which were guided by ultrasonography. A sedation with fentanyl and propofol, and spontaneous ventilation with o2 catheter. Patient maintained with MAP >70 throughout the process, without reacting to the surgical stimulus. At the end of a period of time, the beginning and end of the operation were completed in the ICU, with high frequency for the 24-hour period. She presented a pain score in the hip region and thighs in the last 72 hours, with the walker walking the day after the surgery. Conclusions Review of satisfactory surgical anesthesia, with postoperative analgesia and drastic reduction of opioid consumption, with a rapid recovery of the patient, operating with early disease, without major hemodynamic changes, as an option.
Robotic Surgery for Abdominal Wall Hernia Repair
Scientific reports, Jan 18, 2018
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional ane... more Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10. This is a prospective, randomized controlled trial. Fifty patients were randomized to general anesthesia only or general anesthesia associated with SAM block + PECS I (25 per group). The association of SAM block + PECS I with general anesthesia reduced intraoperative fentanyl consumption, morphine use and visual analog pain scale scores in the post-anesthetic care unit (P...
A&A practice, Jan 23, 2018
We described the first ultrasound-guided erector spinae plane block that provided complete surgic... more We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2.5-hour procedure. At the end of the surgery, patient received morphine 2 mg and dipyrone 2 g intravenously, and demanded no analgesic until 24 hours after the procedure.
Revista brasileira de …, 2011
JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas d... more JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. Com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. Entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos. CONTEÚDO: Uma revisão literária sobre a anatomia da região sacral e da técnica anestésica necessária para a realização adequada do bloqueio caudal foi promovida. Além disso, artigos recentes sobre estudos realizados com bloqueios peridurais caudais guiados por ultrassom tanto em crianças quanto em adultos também foram incluídos. CONCLUSÕES: O ultrassom, apesar de suas limitações, pode ser útil como ferramenta adjuvante no posicionamento da agulha no espaço caudal. Permite a fácil identificação da anatomia sacral, além de visualização da injeção, em tempo real. Sua natureza portátil, não invasiva e livre de exposição à radiação faz dele uma tecnologia atrativa na sala operatória, principalmente na emergência de casos difíceis. Entretanto, como seu uso em bloqueios centrais do neuroeixo ainda é muito primitivo, é necessário que mais pesquisas sejam feitas para se consagre como técnica de rotina na prática anestésica.
Revista brasileira de anestesiologia
The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are f... more The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are few reports in the literature on the learning curve of the ultrasound technique. The objective of this report was to evaluate the learning curve of CET-SMA/HSL Anesthesiology residents of ultrasound-guided peripheral block using an experimental agar model. An experimental model was developed by filling a bowl with agar and olives. Nine residents were randomly divided in three groups (G1, G2, and G3), each one with a R1, a R2, and a R3. All three groups received theoretical explanation. G1 also had two hours of practical training, G2 had one hour, and G3 had no training. Residents were then asked to place a needle at the middle of the olive wall, near the transducer and then reposition the needle between the olive and the bottom of the bowl, simulating the epidural injection of anesthetic. The speed and efficacy of the tasks, as well as technical flaws, were evaluated. The mean length of t...
Brazilian Journal of Anesthesiology, 2011
Revista Brasileira de Anestesiologia, 2012
Revista Brasileira de Anestesiologia, 2011
Resumo: Najman ie, Frederico tN, Segurado AvR, Kimachi PP -Bloqueio Peridural caudal: técnica Ane... more Resumo: Najman ie, Frederico tN, Segurado AvR, Kimachi PP -Bloqueio Peridural caudal: técnica Anestésica de uso exclusivo em crianças? É Possível sua Realização em Adultos? Qual o Papel do Ultrassom nesse contexto? Justificativa e objetivos: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos.
Revista Brasileira de Anestesiologia, 2008
Rev Bras Anestesiol ARTIGO CIENTÍFICO 2008; 58: 2: 106-111 SCIENTIFIC ARTICLE RESUMO Baranauskas ... more Rev Bras Anestesiol ARTIGO CIENTÍFICO 2008; 58: 2: 106-111 SCIENTIFIC ARTICLE RESUMO Baranauskas MB, Margarido CB, Panossian C, Silva ED, Campanella MA, Kimachi PP -Simulação de Bloqueios Periféricos Guiados por Ultra-Som: Curva de Aprendizado dos Residentes de Anestesiologia do CET-SMA/HSL. JUSTIFICATIVA E OBJETIVOS: A técnica de ultra-som tem sido cada vez mais utilizada para a realização de bloqueios de nervos periféricos. Existem poucos relatos na literatura que analisam a curva de aprendizado da técnica de ultra-som. O objetivo do estudo foi avaliar a curva de aprendizado dos residentes de Anestesiologia do CET-SMA/HSL em bloqueios periféricos guiados por ultra-som por meio de modelo experimental de gelatina. MÉTODO: Foi desenvolvido modelo experimental com cuba preenchida de gelatina e azeitona submersa. Nove residentes foram distribuídos aleatoriamente em três grupos (G1, G2 e G3) compostos, cada um, de um R1, um R2 e um R3. Os três grupos receberam explanação teórica. O G1 recebeu duas horas de treinamento prático, o G2 uma hora e o G3 não treinou. Na seqüência, os participantes foram solicitados a posicionar a agulha no ponto médio da parede da azeitona, próximo ao transdutor e reposicionar a agulha entre a azeitona e o fundo da cuba, simulando a injeção perineural do anestésico. Foram avaliadas a velocidade e eficácia das tarefas, além das falhas técnicas. RESULTADOS: O G1 apresentou média de tempo para realização das tarefas de 37,63 segundos, sem falhas técnicas; no G2 observou-se média de 64,40 segundos, ocorrendo duas falhas técnicas e o G3 apresentou média de 93,83 segundos, com 12 falhas técnicas. CONCLUSÕES: O estudo permite concluir que o maior tempo de treinamento em modelo experimental de bloqueios periféricos guiados por ultra-som melhorou a curva de aprendizado na simulação da técnica. SUMMARY Baranauskas MB, Margarido CB, Panossian C, Silva ED, Campanella MA, Kimachi PP -Simulation of Ultrasound-Guided Peripheral Nerve Block: Learning Curve of CET-SMA/HSL Anesthesiology Residents.
Revista brasileira de anestesiologia
Transesophageal echocardiography (TEE) is extremely useful in surgeries like valvuloplasty, of th... more Transesophageal echocardiography (TEE) is extremely useful in surgeries like valvuloplasty, of the thoracic aorta, and correction of congenital cardiopathies. The low degree of invasiveness and the capacity to aggregate information that can change the course of the surgery are among the advantages of TEE. The objective of this report was to present a case in which the surgical conduct was changed due to a new diagnosis provided by intraoperative transesophageal echocardiography, and to emphasize the importance of using the transesophageal echo in surgeries to correct congenital cardiopathies. A 28-year old female, ASA II, with a history of dyspnea progressing from medium to small efforts was referred by another department for elective surgical correction of stenosis of the pulmonary valve diagnosed by transthoracic echocardiography. Intraoperative transesophageal echocardiography showed patent foramen ovale, infundibular stenosis of the right ventricular outlet, and perimembranous s...
Revista brasileira de anestesiologia
Since its introduction in the 80s, transesophageal echocardiography (TEE) not only gained popular... more Since its introduction in the 80s, transesophageal echocardiography (TEE) not only gained popularity but also experienced great advances in technology and currently it is an extremely valuable tool in the intraoperative period. In Brazil, there are no published data on the profile of its use in the intraoperative period by anesthesiologists. The objective of this study was to describe the use of intraoperative TEE in an Anesthesiology Service in a tertiary private hospital. Retrospective study from completed medical charts in all cases where the patient was monitored with TEE. Monitoring was applied in patients classified as I-II according to the American Society of Echocardiography and presenting no contraindication to the examination. At the end of procedure, after examination, a note on the chart classified monitoring according to its usefulness in the intraoperative period into three groups: group 1, no interference of TEE in anesthetic or surgical approach; group 2, TEE prompte...
Revista Brasileira de Anestesiologia, 2010
Page 1. Revista Brasileira de Anestesiologia 111 Vol. 60, No 2, Marzo-Abril, 2010 Rev Bras Aneste... more Page 1. Revista Brasileira de Anestesiologia 111 Vol. 60, No 2, Marzo-Abril, 2010 Rev Bras Anestesiol INFORMACIONES CLÍNICAS 2010; 60: 2: 111-113 * Recibido del Hospital Sírio-Libanês, São Paulo, SP 1. Anestesiólogo del São Paulo Servicios Médicos de Anestesia ...
Revista Brasileira de Anestesiologia, 2009
... seleciona. para imprimir. Fotocópia. Texto completo SciELO Brasil (texto : PT). experimental,... more ... seleciona. para imprimir. Fotocópia. Texto completo SciELO Brasil (texto : PT). experimental, Documentos relacionados. Id: 533888. Autor: Silva, Alexander Alves da; Silva, Enis Donizetti; Segurado, Arthur Vitor Rosenti; Kimachi, Pedro Paulo; Simões, Claudia Marquez. ...
Journal of Cardiothoracic and Vascular Anesthesia, 2006
Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, bu... more Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, but in patients with congenital cardiopathy its incidence ranges from 3% to 10%. The objective of this report was to present a case of intraoperative diagnosis with transesophageal echocardiography and to emphasize the importance of its routine use in surgical procedures for correction of congenital cardiopathies. This is a 16-year old male patient, ASA II, with a diagnosis of superior sinus venosus interatrial communication (IAC) with partial anomalous drainage of the pulmonary veins scheduled for the surgical correction of the cardiopathy. After induction of general anesthesia, transesophageal echocardiography (TEE) showed initially a dilation of the right cardiac chambers, a 17-mm superior sinus venosus IAC, anomalous drainage of the right superior pulmonary vein draining into the right superior vena cava (SVC), and dilation of the coronary sinus raising the possibility of persistent left superior vena cava. To confirm this suspicion, 10 mL of NS (works as a contrast in echocardiography) were injected in the venous access of the left arm, and microbubbles crossing the coronary sinus were observed immediately afterwards confirming the diagnosis of persistent left superior vena cava. Routine intraoperative transesophageal echocardiography in patients with congenital cardiopathy is a fundamental auxiliary method, not only for the surgeon, often having direct influence on the surgical technique used, but also for the anesthesiologist, who can get useful information for the hemodynamic management of the patient.
Food Quality and Preference, 2013
E-Poster Viewing Abstracts, 2019
Background and aims Treatment crises are frequent in the elderly population, usually with comorbi... more Background and aims Treatment crises are frequent in the elderly population, usually with comorbidities that may prolong the hospitalization of these patients. The great interest is a quick recovery, but with an efficient analgesia that allows an early mobilization of the patients. Methods Case report Results Patient is 91 years old, ASA II, who is presenting with left transtrocantical fracture, discrete mental and previous history of abdominal distension and nausea with the use of PCA morphine. The association was associated with blockage of the supinguinguinal iliac fascia associated with the PENG block before surgery, avoiding hemodynamic repercussions of the neuraxis, but maintaining the benefits and discussed regional anesthesia. 20 ml of lidocaine 2% + 4 mg of dexamethasone without iliac fascia and 20 ml of ropivacaine 0.375% + 6 mg dexamethasone were used in the PENG block, both of which were guided by ultrasonography. A sedation with fentanyl and propofol, and spontaneous ventilation with o2 catheter. Patient maintained with MAP >70 throughout the process, without reacting to the surgical stimulus. At the end of a period of time, the beginning and end of the operation were completed in the ICU, with high frequency for the 24-hour period. She presented a pain score in the hip region and thighs in the last 72 hours, with the walker walking the day after the surgery. Conclusions Review of satisfactory surgical anesthesia, with postoperative analgesia and drastic reduction of opioid consumption, with a rapid recovery of the patient, operating with early disease, without major hemodynamic changes, as an option.
Robotic Surgery for Abdominal Wall Hernia Repair
Scientific reports, Jan 18, 2018
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional ane... more Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10. This is a prospective, randomized controlled trial. Fifty patients were randomized to general anesthesia only or general anesthesia associated with SAM block + PECS I (25 per group). The association of SAM block + PECS I with general anesthesia reduced intraoperative fentanyl consumption, morphine use and visual analog pain scale scores in the post-anesthetic care unit (P...
A&A practice, Jan 23, 2018
We described the first ultrasound-guided erector spinae plane block that provided complete surgic... more We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2.5-hour procedure. At the end of the surgery, patient received morphine 2 mg and dipyrone 2 g intravenously, and demanded no analgesic until 24 hours after the procedure.
Revista brasileira de …, 2011
JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas d... more JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. Com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. Entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos. CONTEÚDO: Uma revisão literária sobre a anatomia da região sacral e da técnica anestésica necessária para a realização adequada do bloqueio caudal foi promovida. Além disso, artigos recentes sobre estudos realizados com bloqueios peridurais caudais guiados por ultrassom tanto em crianças quanto em adultos também foram incluídos. CONCLUSÕES: O ultrassom, apesar de suas limitações, pode ser útil como ferramenta adjuvante no posicionamento da agulha no espaço caudal. Permite a fácil identificação da anatomia sacral, além de visualização da injeção, em tempo real. Sua natureza portátil, não invasiva e livre de exposição à radiação faz dele uma tecnologia atrativa na sala operatória, principalmente na emergência de casos difíceis. Entretanto, como seu uso em bloqueios centrais do neuroeixo ainda é muito primitivo, é necessário que mais pesquisas sejam feitas para se consagre como técnica de rotina na prática anestésica.
Revista brasileira de anestesiologia
The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are f... more The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are few reports in the literature on the learning curve of the ultrasound technique. The objective of this report was to evaluate the learning curve of CET-SMA/HSL Anesthesiology residents of ultrasound-guided peripheral block using an experimental agar model. An experimental model was developed by filling a bowl with agar and olives. Nine residents were randomly divided in three groups (G1, G2, and G3), each one with a R1, a R2, and a R3. All three groups received theoretical explanation. G1 also had two hours of practical training, G2 had one hour, and G3 had no training. Residents were then asked to place a needle at the middle of the olive wall, near the transducer and then reposition the needle between the olive and the bottom of the bowl, simulating the epidural injection of anesthetic. The speed and efficacy of the tasks, as well as technical flaws, were evaluated. The mean length of t...
Brazilian Journal of Anesthesiology, 2011
Revista Brasileira de Anestesiologia, 2012
Revista Brasileira de Anestesiologia, 2011
Resumo: Najman ie, Frederico tN, Segurado AvR, Kimachi PP -Bloqueio Peridural caudal: técnica Ane... more Resumo: Najman ie, Frederico tN, Segurado AvR, Kimachi PP -Bloqueio Peridural caudal: técnica Anestésica de uso exclusivo em crianças? É Possível sua Realização em Adultos? Qual o Papel do Ultrassom nesse contexto? Justificativa e objetivos: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos.
Revista Brasileira de Anestesiologia, 2008
Rev Bras Anestesiol ARTIGO CIENTÍFICO 2008; 58: 2: 106-111 SCIENTIFIC ARTICLE RESUMO Baranauskas ... more Rev Bras Anestesiol ARTIGO CIENTÍFICO 2008; 58: 2: 106-111 SCIENTIFIC ARTICLE RESUMO Baranauskas MB, Margarido CB, Panossian C, Silva ED, Campanella MA, Kimachi PP -Simulação de Bloqueios Periféricos Guiados por Ultra-Som: Curva de Aprendizado dos Residentes de Anestesiologia do CET-SMA/HSL. JUSTIFICATIVA E OBJETIVOS: A técnica de ultra-som tem sido cada vez mais utilizada para a realização de bloqueios de nervos periféricos. Existem poucos relatos na literatura que analisam a curva de aprendizado da técnica de ultra-som. O objetivo do estudo foi avaliar a curva de aprendizado dos residentes de Anestesiologia do CET-SMA/HSL em bloqueios periféricos guiados por ultra-som por meio de modelo experimental de gelatina. MÉTODO: Foi desenvolvido modelo experimental com cuba preenchida de gelatina e azeitona submersa. Nove residentes foram distribuídos aleatoriamente em três grupos (G1, G2 e G3) compostos, cada um, de um R1, um R2 e um R3. Os três grupos receberam explanação teórica. O G1 recebeu duas horas de treinamento prático, o G2 uma hora e o G3 não treinou. Na seqüência, os participantes foram solicitados a posicionar a agulha no ponto médio da parede da azeitona, próximo ao transdutor e reposicionar a agulha entre a azeitona e o fundo da cuba, simulando a injeção perineural do anestésico. Foram avaliadas a velocidade e eficácia das tarefas, além das falhas técnicas. RESULTADOS: O G1 apresentou média de tempo para realização das tarefas de 37,63 segundos, sem falhas técnicas; no G2 observou-se média de 64,40 segundos, ocorrendo duas falhas técnicas e o G3 apresentou média de 93,83 segundos, com 12 falhas técnicas. CONCLUSÕES: O estudo permite concluir que o maior tempo de treinamento em modelo experimental de bloqueios periféricos guiados por ultra-som melhorou a curva de aprendizado na simulação da técnica. SUMMARY Baranauskas MB, Margarido CB, Panossian C, Silva ED, Campanella MA, Kimachi PP -Simulation of Ultrasound-Guided Peripheral Nerve Block: Learning Curve of CET-SMA/HSL Anesthesiology Residents.
Revista brasileira de anestesiologia
Transesophageal echocardiography (TEE) is extremely useful in surgeries like valvuloplasty, of th... more Transesophageal echocardiography (TEE) is extremely useful in surgeries like valvuloplasty, of the thoracic aorta, and correction of congenital cardiopathies. The low degree of invasiveness and the capacity to aggregate information that can change the course of the surgery are among the advantages of TEE. The objective of this report was to present a case in which the surgical conduct was changed due to a new diagnosis provided by intraoperative transesophageal echocardiography, and to emphasize the importance of using the transesophageal echo in surgeries to correct congenital cardiopathies. A 28-year old female, ASA II, with a history of dyspnea progressing from medium to small efforts was referred by another department for elective surgical correction of stenosis of the pulmonary valve diagnosed by transthoracic echocardiography. Intraoperative transesophageal echocardiography showed patent foramen ovale, infundibular stenosis of the right ventricular outlet, and perimembranous s...
Revista brasileira de anestesiologia
Since its introduction in the 80s, transesophageal echocardiography (TEE) not only gained popular... more Since its introduction in the 80s, transesophageal echocardiography (TEE) not only gained popularity but also experienced great advances in technology and currently it is an extremely valuable tool in the intraoperative period. In Brazil, there are no published data on the profile of its use in the intraoperative period by anesthesiologists. The objective of this study was to describe the use of intraoperative TEE in an Anesthesiology Service in a tertiary private hospital. Retrospective study from completed medical charts in all cases where the patient was monitored with TEE. Monitoring was applied in patients classified as I-II according to the American Society of Echocardiography and presenting no contraindication to the examination. At the end of procedure, after examination, a note on the chart classified monitoring according to its usefulness in the intraoperative period into three groups: group 1, no interference of TEE in anesthetic or surgical approach; group 2, TEE prompte...
Revista Brasileira de Anestesiologia, 2010
Page 1. Revista Brasileira de Anestesiologia 111 Vol. 60, No 2, Marzo-Abril, 2010 Rev Bras Aneste... more Page 1. Revista Brasileira de Anestesiologia 111 Vol. 60, No 2, Marzo-Abril, 2010 Rev Bras Anestesiol INFORMACIONES CLÍNICAS 2010; 60: 2: 111-113 * Recibido del Hospital Sírio-Libanês, São Paulo, SP 1. Anestesiólogo del São Paulo Servicios Médicos de Anestesia ...
Revista Brasileira de Anestesiologia, 2009
... seleciona. para imprimir. Fotocópia. Texto completo SciELO Brasil (texto : PT). experimental,... more ... seleciona. para imprimir. Fotocópia. Texto completo SciELO Brasil (texto : PT). experimental, Documentos relacionados. Id: 533888. Autor: Silva, Alexander Alves da; Silva, Enis Donizetti; Segurado, Arthur Vitor Rosenti; Kimachi, Pedro Paulo; Simões, Claudia Marquez. ...
Journal of Cardiothoracic and Vascular Anesthesia, 2006
Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, bu... more Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, but in patients with congenital cardiopathy its incidence ranges from 3% to 10%. The objective of this report was to present a case of intraoperative diagnosis with transesophageal echocardiography and to emphasize the importance of its routine use in surgical procedures for correction of congenital cardiopathies. This is a 16-year old male patient, ASA II, with a diagnosis of superior sinus venosus interatrial communication (IAC) with partial anomalous drainage of the pulmonary veins scheduled for the surgical correction of the cardiopathy. After induction of general anesthesia, transesophageal echocardiography (TEE) showed initially a dilation of the right cardiac chambers, a 17-mm superior sinus venosus IAC, anomalous drainage of the right superior pulmonary vein draining into the right superior vena cava (SVC), and dilation of the coronary sinus raising the possibility of persistent left superior vena cava. To confirm this suspicion, 10 mL of NS (works as a contrast in echocardiography) were injected in the venous access of the left arm, and microbubbles crossing the coronary sinus were observed immediately afterwards confirming the diagnosis of persistent left superior vena cava. Routine intraoperative transesophageal echocardiography in patients with congenital cardiopathy is a fundamental auxiliary method, not only for the surgeon, often having direct influence on the surgical technique used, but also for the anesthesiologist, who can get useful information for the hemodynamic management of the patient.
Food Quality and Preference, 2013