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Search Results: 1 - 10 of 126620 matches for " Pedro Thadeu Galv?o Vianna "
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Monitor de profundidade da hipnose. A eletroencefalografia bispectral
Vianna, Pedro Thadeu Galvo;
Revista Brasileira de Anestesiologia , 2001, DOI: 10.1590/S0034-70942001000500008
Abstract: background and objectives: monitoring the "depth" of anesthesia is a complex process. most approaches to monitoring anesthetic adequacy involve eeg waves or, more recently, some eeg processed form. bispectral analysis is a method which allows for eeg analysis in different frequency phases. contents: processed eeg starts with the digitalization of the eeg signal. the digitized eeg can then be mathematically transformed by a process known as fourier analysis, which divides the complex eeg signal in a number of sine wave components, that is, in each portion of different amplitude, but whose sum corresponds to the original eeg waveform. many parameters are derived from this method. bispectral index, or simply bis (100 = awaken to 0= eeg isoelectric) is derived from the best parameters (e.g. spectral edge frequency, median frequency and burst suppression) which are evaluated by statistical analysis. conclusions: clinical experience has shown that bis may predict a response to skin incision during anesthesia. however, bis is not independent of the anesthetic technique. there are different responses depending on which hypnotics or analgesics are used.
Two-Hour Creatinine Clearance and Glomerular Filtration Rate Estimated from Serum Cystatin C and Creatinine in the Elderly to Preoperative Period  [PDF]
Leopoldo Muniz da Silva, Pedro Thadeu Galvo Vianna, Mariana Takaku, Glênio Bittencourt Mizubuti, Yara Marcondes Machado Castiglia
Open Journal of Nephrology (OJNeph) , 2013, DOI: 10.4236/ojneph.2013.34032

Introduction: The utility of estimates of glomerular filtration rate based on creatinine and cystatin C serum levels to assess renal function in older surgical patients remains to be determined. Objective: To determine whether 2h-creatinine clearance (CrCl-2h) can be an adequate substitute for glomerular filtration rate estimates obtained by measuring serum cystatin C and creatinine in the elderly at preoperation. Methods: A total of 102 consecutive elder patients undergoing pre-anesthesia evaluation for routine surgeries were included. Study subjects were allocated into three groups: Group 1 (G1)—hypertensive diabetic patients, Group 2 (G2)—hypertensive patients, and Group 3 (G3)—non-hypertensive and non-diabetic patients. Two-hour urine collection was performed and CrCl-2h adjusted for ultrasonic residual bladder volume was estimated. GFR was estimated based on creatinine and cystatin C serum levels. Bland-Altman analysis was used to compare methods. Results: The mean difference between the evaluated methods and CrCl-2h was <15 mL·min-1·1.73 m-2 for Cys-GFR, and >20 mL·min-1·1.73 m

Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac  [PDF]
Tiago Pechutti Medeiros, Pedro Thadeu Galvo Vianna, Leopoldo Muniz da Silva, Lídia Raquel de Carvalho, Gilberto Elias Wady, Leandro Gobbo Braz, Yara Marcondes Machado Castiglia
Health (Health) , 2013, DOI: 10.4236/health.2013.511A1005

Background: Laparoscopic cholecystectomy (LC) reduces surgical trauma and hospital stay, but requires effective and safe postoperative analgesia. This prospective and double-blind study investigated the effects of analgesia with tramadol combined with either dipyrone or ketorolac on the postoperative renal function of patients submitted to LC. Methods: Pre-and post-operatively (PO), estimated glomerular filtration rates (GFR), obtained by two formulas dependent on blood Cr and one on blood cystatin C values, and tubular enzymuria—alkaline phosphatase (AP), γ-glutamiltransferase (γ-GT)— were determined in well hydrated patients who underwent LC and analgesia with tramadol combined with either dipyrone (Dipyrone, n = 63) or ketorolac (Ketorolac, n = 63). Upon discharge from the post-anesthetic care unit (PACU), pain (through Verbal Numerical Scale—VNS) and need for rescue analgesia with morphine were evaluated. Results: There was hemodilution PO, which made GFR profile analysis more difficult—those dependent on Cr increased and statistically correlated, but those dependent on cystatin C did not change. There was a significant PO increase in AP in the Dipyrone and Ketorolac groups, and in the product of the both enzymes in the Ketorolac group. Upon PACU discharge, the Dipyrone group showed signifi

cantly higher VNS scores than the Ketorolac group. All patients received morphine PO, and the total dose needed for pain control differed between groups, but without statistical significance. Conclusions: The association of tramadol with dipyrone or ketorolac in well hydrated patients submitted to LC had similar analgesic effectiveness in the PACU. Postoperatively, the effect on GFR may have been masked by hemodilution, and enzymuria was discreetly enhanced when ketorolac was used.

Efeitos renais e cardiovasculares da infus?o de dopamina e da solu??o de cloreto de sódio a 7,5%: estudo experimental em c?es com restri??o hídrica
Verderese, Marisa Aparecida Lima;Vianna, Pedro Thadeu Galvo;Ganem, Eliana Marisa;Vane, Luiz Antonio;
Revista Brasileira de Anestesiologia , 2003, DOI: 10.1590/S0034-70942003000500007
Abstract: background and objectives: dopamine infusion for renal protection is controversial. this study aimed at observing the effects of dopamine, hypertonic solution and the association of both in dogs with water restriction, emulating preoperative fast. methods: the following renal function parameters were studied in 32 dogs anesthetized with sodium pentobarbital and fentanyl: effective renal plasma flow (sodium para-aminohippurate clearance), glomerular filtration rate (creatinine clearance), sodium, potassium and osmolar clearance, sodium and potassium fractional excretion and renal vascular resistance. cardiovascular parameters were: mean blood pressure, heart rate, inferior vena cava pressure, cardiac index, hematocrit and peripheral vascular resistance index. animals were randomly distributed in four experimental groups: group 1 - g1 (n = 8) - control group; group 2 - g2 (n = 8) - dopamine infusion (2 μg.kg-1.min-1); group 3 - g3 (n = 8) - 7.5% sodium chloride (2 ml.kg-1) and group 4 - g4 (n = 8) - association of dopamine (2 μg.kg-1.min-1) and 7.5% sodium chloride (2 ml.kg-1). groups underwent four experimental stages lasting 30 minutes each, and involving moments m1, m2, m3 and m4. results: dopamine group (g2) had mean blood pressure, renal vascular resistance and potassium excretion decrease. hypertonic sodium chloride group (g3) had cardiac index, urinary volume, sodium and potassium clearance, sodium and potassium urinary excretion and sodium fractional excretion increase. group receiving the association of hypertonic solution and dopamine (g4) had heart rate, cardiac index, effective renal plasma flow and sodium urinary excretion increase; there has also been systemic vascular resistance and plasma potassium index decrease. conclusions: our conclusion was that hypertonic sodium chloride solution was able to improve hemodynamic conditions and, as a consequence, renal function of dogs under 12-hour water restriction. the same was not true for 2 μg.kg-1.min-1 dopam
Complica??es neurológicas determinadas pela anestesia subaracnóidea
Ganem, Eliana Marisa;Castiglia, Yara Marcondes Machado;Vianna, Pedro Thadeu Galvo;
Revista Brasileira de Anestesiologia , 2002, DOI: 10.1590/S0034-70942002000400012
Abstract: background and objectives: although rare, spinal anesthesia-induced neurological complications may determine serious sequelae. this study aimed at presenting these complications in order to elucidate triggering factors and help in the diagnosis of such injuries. contents: the following complications are presented: needle and catheter-induced nerve injury, post dural puncture headache, anterior spinal artery syndrome, spinal hematoma, septic meningitis, aseptic meningitis, adhesive arachnoiditis, cauda equina syndrome, and transient neurological symptoms. conclusions: the understanding of triggering factors of spinal anesthesia-induced neurological complications may prevent injuries and help early diagnosis and treatment, therefore changing patients prognosis.
Altera??es hemodinamicas durante o pneumoperit?nio em c?es ventilados com volume e press?o controlados
Almeida, Armando Vieira de;Ganem, Eliana Marisa;Carraretto, Ant?nio Roberto;Vianna, Pedro Thadeu Galvo;
Revista Brasileira de Anestesiologia , 2003, DOI: 10.1590/S0034-70942003000600007
Abstract: background and objectives: there are no studies associating ventilation-induced effects and hemodynamic changes during pneumoperitoneum. this study aimed at evaluating hemodynamic changes determined by pneumoperitoneum in dogs under volume and pressure controlled ventilation. methods: the study involved 16 dogs anesthetized with sodium thiopental and fentanyl, divided in group 1: volume controlled; and group 2: pressure controlled; submitted to 10 and 15 mmhg pneumoperitoneum. the following parameters were evaluated: heart rate, mean blood pressure, right atrium pressure, pulmonary capillary wedge pressure, cardiac index, systemic vascular resistance index and plasma vasopressin. data were collected in four moments: m1 - before pneumoperitoneum, m2 - 30 minutes after 10 mmhg pneumoperitoneum; m3 - 30 minutes after 15 mmhg pneumoperitoneum; m4 - 30 minutes after pneumoperitoneum deflation. results: results have shown increased cardiac index, right atrium pressure and pulmonary capillary wedge pressure in m2 and m3 for all groups. vasopressin was not changed during procedure and systemic vascular resistance index has not increased, providing mean blood pressure stability for both groups. conclusions: ventilation modes have not determined hemodynamic differences between studied groups. anesthetic technique and intra-abdominal pressure have determined mean blood pressure stability, probably due to the absence of systemic vascular resistance index increase.
Estudo comparativo dos efeitos hemodinamicos e ventilatórios da ventila??o controlada a volume ou a press?o, em c?es submetidos ao pneumoperit?nio
Carraretto, Antonio Roberto;Vianna, Pedro Thadeu Galvo;Almeida, Armando Vieira de;Ganem, Eliana Marisa;
Revista Brasileira de Anestesiologia , 2005, DOI: 10.1590/S0034-70942005000600007
Abstract: background and objectives: pressure controlled ventilation (pcv) is available in anesthesia machines, but there are no studies on its use during co2 pneumoperitoneum (cpp). this study aimed at evaluating pressure-controlled ventilation and hemodynamic and ventilatory changes during cpp, as compared to conventional volume controlled ventilation (vcv). methods: this study involved 16 dogs anesthetized with thiopental, fentanyl and pancuronium, which were randomly assigned to two groups: vc - volume controlled ventilation (n=8) and pc - pressure controlled ventilation (n=8). hemodynamic and ventilatory parameters were monitored and recorded in 4 moments: m1 (before cpp), m2 (30 minutes after cpp = 10 mmhg), m3 (30 minutes after cpp=15 mmhg) and m4 (30 minutes after deflation). results: with cpp, there has been significant increase in tidal volume in pc group; there has been increase in airway pressures (peak and plateau), decrease in compliance with increase in cpp pressure, increase in heart rate, maintenance of mean blood pressure with higher values in the vc group in all stages; there was also increase in right atrium pressure with significant decrease after deflation, decrease in arterial ph with minor variations in pc group, greater arterial pco2 stability in pc group, and no significant changes in arterial po2. conclusions: there were some differences in hemodynamic and ventilatory data between both ventilation control modes (vc and pc). it is possible to use pressure controlled ventilation during cpp, but the anesthesiologist must monitor and take a close look at alveolar ventilation, adjusting inspiratory pressure to ensure proper co2 elimination and oxygenation.
Efeitos hemodinamicos e renais da inje??o de doses elevadas de clonidina no espa?o peridural do c?o
Roso, Nilson Camargo;Vianna, Pedro Thadeu Galvo;Castiglia, Yara Marcondes Machado;Braz, José Reinaldo Cerqueira;
Revista Brasileira de Anestesiologia , 2005, DOI: 10.1590/S0034-70942005000300007
Abstract: background and objectives: there are no studies reporting renal effects promoted by high epidural clonidine doses. this study aimed at evaluating hemodynamic and renal effects of high epidural clonidine doses in dogs. methods: this double-blind randomized study involved 20 animals anesthetized with sodium thiopental and fentanyl, which were distributed in two groups: group 1 or placebo (n = 10), receiving 0.2 ml.kg-1 saline, and group 2 or clonidine (n = 10), receiving 0.2 ml.kg-1 of a solution with 50 μg.ml-1 clonidine in the epidural space. the following hemodynamic parameters were evaluated: heart rate (hr): beat.min-1; mean blood pressure (mbp): mmhg; pulmonary capillary wedge pressure (pcwp): mmhg; cardiac output (co): l.min-1; and systolic volume (sv): ml. the following renal function parameters were also evaluated: renal blood flow (rbf) ml.min-1; renal vascular resistance (rvr): mmhg.ml-1; urinary minute volume (umv): ml.min-1; creatinine clearance (ccr): ml.min-1; para-aminohippurate clearance (cpah): ml.min-1; filtration fraction (ff); sodium clearance (cna): ml.min-1; potassium clearance (ck): ml.min-1; sodium fractional excretion (fena): %; sodium urinary excretion (unav): μeq.min-1; potassium urinary excretion (ukv): μeq.min-1. experiment consisted of three 20-minute moments. data were collected at 10 minutes of each moment and diuresis was measured in the beginning and end of each moment. at the end of m1, clonidine or saline were epidurally injected. after 20 minutes data were repeated in m2 and m3. results: epidural 10 μg.kg-1 clonidine in dogs has promoted significant changes with decreased heart rate and cardiac output and increased sodium para-aminophurate clearance/cardiac output ratio. conclusions: in our conditions and doses, clonidine has not promoted renal function changes, but has decreased hemodynamic parameters (heart rate and cardiac output).
Efeitos cardiovasculares e renais da inje??o intra-arterial de contraste radiológico i?nico em c?es com restri??o hídrica
Verderese, Marisa Aparecida Lima;Vianna, Pedro Thadeu Galvo;Castiglia, Yara Marcondes Machado;Vane, Luiz Antonio;
Revista Brasileira de Anestesiologia , 2005, DOI: 10.1590/S0034-70942005000200005
Abstract: background and objectives: this study aimed at evaluating acute radiological contrast effects in fluid restriction situations, observing renal and cardiovascular effects after intra-arterial injection of high osmolarity radiological contrast. methods: participated in this study 16 dogs anesthetized with sodium thiopental (15 mg.kg-1) and fentanyl (0.03 ml.kg-1), followed by continuous infusion of 40 μg.kg-1.min-1 (sodium thiopental) and 0.1 μg.kg-1.min-1 (fentanyl). hydration was achieved with 5% glucose solution (0.03 ml.kg-1.min-1) and ventilation was mechanically controlled with compressed air. the following attributes were evaluated: heart rate (hr); mean blood pressure (mbp); inferior vena cava pressure (ivp); cardiac output (co); hematocrit (ht); effective renal plasma flow (erpf); renal blood flow (rbf); glomerular filtration rate (gfr); filtration fraction; renal vascular resistance (rvr), urinary volume (uv); plasma and urinary osmolarity; osmolar clearance; free water clearance; sodium and potassium clearance; plasma sodium and potassium; sodium and potassium urinary fractional excretion and rectal temperature. these attributes were evaluated in four moments: 30 (m1), 60 (m2), 90 (m3) and 120 (m4) minutes after sodium para-aminohipurate and creatinine administration (beginning of experiment). in moment 2, g1 received intra-arterial 0.9% saline (1.24 ml.kg-1) and g2 received intra-arterial radiological contrast (1.4 ml.kg-1). results: group g1 has presented increased hr, erpf, rbf, plasma osmolarity, sodium clearance and sodium urinary excretion, in addition to decreased urinary osmolarity, plasma sodium, potassium clearance and rectal temperature. group g2 has presented increased hr, rvr, uv, osmolar clearance, sodium clearance and sodium urinary and fractional excretion; there has also been decrease in hematocrit, glomerular filtration rate, filtration fraction, urinary osmolarity, free water clearance, urinary sodium and potassium, plasma potassium and r
Complete atrioventricular block during renal transplantation in a patient with Alport's syndrome: case report
Ferrari, Fábio;Nascimento Junior, Paulo do;Vianna, Pedro Thadeu Galvo;
Sao Paulo Medical Journal , 2001, DOI: 10.1590/S1516-31802001000500007
Abstract: context: patients with alport's syndrome (causing 5% of end-stage renal disease) have a higher risk of heart conduction abnormalities. objective: to report a case of alport's syndrome developing complete atrioventricular block during renal transplantation. case report: a 21-year-old man with chronic renal failure due to alport's syndrome was submitted to a renal transplantation under epidural anesthesia and, during the intraoperative period, a complete atrioventricular block was diagnosed and promptly treated with a transcutaneous pacemaker. this extensive sympathetic block can contribute towards disturbances in the heart conduction system, particularly in patients with chronic renal disease in hemodialysis. even in patients with a normal preoperative electrocardiogram or no conduction system disturbances, some degree of atrioventricular block, including complete atrioventricular block, can occur. in this situation, a transcutaneous pacemaker provides rapid and effective treatment in the operating room, thereby permitting the planning of a definitive treatment.
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