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Search Results: 1 - 10 of 10575 matches for " Yara Marcondes Machado Castiglia "
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Renal Function after Coronary Artery Bypass Graft Using Dexmedetomidine  [PDF]
Alexandre Fabricio Martucci, Yara Marcondes Machado Castiglia
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.39088

Acute kidney injury (AKI) is defined by 0.3 mg/dL increase in serum creatinine (SCr) and is associated with higher incidence of postoperative mortality after coronary artery bypass graft (CABG). There are few clinical studies on the effect of dexmedetomidine (DEX) on renal function. We evaluated AKI after coronary artery bypass graft with and without cardiopulmonary bypass (CPB) under anesthesia with DEX. Method: In this retrospective study, we performed serial analysis of serum creatinine (SCr) up to 48 hours after surgery in 286 patients who underwent CABG. We tested the similarities between groups, evaluating patients separately for use of CPB and DEX. Each patient was evaluated for his or her SCr at the following points in time: preoperative, immediately postoperative, 24 hours postoperative, and 48 hours postoperative. Preoperative SCr was used as the baseline value for each patient. If the SCr increased ≥0.3 mg/dL in at least one of the periods, the patient was classified as having AKI. We also assessed the risk for AKI in patients with altered preoperative SCr (values between 1.1 to 2.0 mg/dL for women or 1.3 to 2.0 mg/dL for men) compared to patients with normal SCr. Results: The groups were similar for preoperative weight, age, and altered SCr. Patients were anesthetized with DEX and who underwent CPB exhibited higher incidence of AKI (p = 0.043). Without CPB, there was higher incidence of AKI after using DEX (p = 0.066). Conclusion

Anestesia na Pré-Eclampsia
Ganem, Eliana Marisa;Castiglia, Yara Marcondes Machado;
Revista Brasileira de Anestesiologia , 2002, DOI: 10.1590/S0034-70942002000400013
Abstract: background and objectives: although affecting a small obstetric population, pre-eclampsia is responsible for considerable maternal morbidity and mortality. therefore, the adequate anesthetic control of this group is yet a challenge for anesthesiologists. this paper aimed at presenting pathophysiology, pharmacological treatment and anesthetic options to normal or surgical delivery in pre-eclampsia patients. contents: classification and terminology of pregnancy-induced arterial hypertension, its pathophysiology, changes in different systems and organs, general principles for patients control and anesthetic options for normal or surgical delivery are described. conclusions: the anesthesiologist?s knowledge of the pathophysiology, treatment options, and pharmacological characteristics of drugs used to control arterial hypertension and prevent seizures, as well as their interactions with anesthetic drugs and techniques, may decrease perioperative complications and maternal and fetal mortality.
Anestesia na Pré-Eclampsia
Ganem Eliana Marisa,Castiglia Yara Marcondes Machado
Revista Brasileira de Anestesiologia , 2002,
Abstract: JUSTIFICATIVA E OBJETIVOS: Embora a pré-eclampsia acometa pequena porcentagem da popula o obstétrica, ela é responsável por considerável morbidade e mortalidade maternas. Assim sendo, o controle anestésico adequado deste grupo de pacientes ainda hoje é um desafio para os anestesiologistas. Este artigo tem a finalidade de apresentar a fisiopatologia, o tratamento farmacológico e as op es anestésicas para o parto normal ou cirúrgico, em pacientes com pré-eclampsia. CONTEúDO: Est o descritos a classifica o e terminologia da hipertens o arterial induzida pela gesta o, a fisiopatologia, as altera es nos diversos órg os e sistemas, os princípios gerais no controle das pacientes e as op es anestésicas para o parto normal e cirúrgico. CONCLUS ES: O conhecimento, pelo anestesiologista, da fisiopatologia, das formas de tratamento e das características farmacológicas das drogas utilizadas para o controle da hipertens o arterial e a profilaxia das convuls es, assim como sua intera o com as drogas e técnicas anestésicas, possibilita a redu o das complica es peri-operatórias e da mortalidade materna e fetal.
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 Galv?o 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

Inje??o intravascular acidental de ropivacaína a 0,5% durante a realiza??o de anestesia peridural torácica: relato de casos
Curtis, Fábio Geraldo;Furlani, Robson;Castiglia, Yara Marcondes Machado;
Revista Brasileira de Anestesiologia , 2004, DOI: 10.1590/S0034-70942004000600009
Abstract: background and objectives: ropivacaine was introduced in the clinical practice a little more than 10 years ago, and has been associated to low risk for central nervous system and cardiovascular complications. these reports aimed at presenting a case of cardiac arrest and another one of neurological toxicity after accidental intravascular ropivacaine injection during epidural anesthesia. case reports: two patients undergoing cosmetic plastic surgeries were submitted to thoracic epidural anesthesia with 0.5% ropivacaine. after anesthetic injection, one has presented cardiac arrest in asystole and the other had signs of neurological toxicity. patients were promptly treated and presented fast recovery, in a way that both surgical procedures could be performed. conclusions: the prompt identification and treatment of the accidental intravascular injection, as well as ropivacaine pharmacological profile, were decisive in both cases for the satisfactory recovery of our patients.
Anestesia subaracnóidea em crian?as
Módolo, Norma Sueli Pinheiro;Castiglia, Yara Marcondes Machado;
Revista Brasileira de Anestesiologia , 2001, DOI: 10.1590/S0034-70942001000600009
Abstract: background and objectives: pediatric spinal anesthesia has gained popularity mainly as an alternative to general anesthesia in pre-term neonates at risk for developing neonatal apnea. this study aimed at evaluating anatomic, physiologic and pharmacological differences of the technique in children. contents: spinal anesthesia in children is being used since the early 20th century, but was overlooked for many years due to the introduction of inhalational anesthetics and neuromuscular blockers. it regained popularity in 1979. its positive effects in pediatric anesthesia are cardiovascular stability in children up to 8 years of age, satisfactory analgesia and muscle relaxation. most popular pediatric anesthetics are tetracaine and bupivacaine in doses adjusted to body weight, but this technique is limited by a relatively short duration of anesthesia. surgical procedures cannot last more than 90 min and there is no satisfactory postoperative pain control. complications are the same for adult patients and include post-dural puncture headache and transient radicular irritation. indications are: lower abdomen, genitalia, perineal region, lower limbs and, in some cases, even thoracic surgeries. it is particularly attractive for pre-term neonates at higher risk for postoperative apnea after general anesthesia. conclusions: spinal anesthesia in children is a relatively safe technique with few complications and may be considered an alternative for general anesthesia, especially for pre-term neonates at risk for postoperative respiratory complications.
Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac  [PDF]
Tiago Pechutti Medeiros, Pedro Thadeu Galv?o 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.

Right-to-left shunt determination in dog lungs under inhalation anesthesia with rebreathing and non-rebreathing system
Rosa, André Leguthe;Mota, Patrícia Cristina Azevedo;Castiglia, Yara Marcondes Machado;
Acta Cirurgica Brasileira , 2006, DOI: 10.1590/S0102-86502006000600004
Abstract: purpose: to investigatge right-to-left shunt determination in dog lungs under inhalantion anesthesia with non-rebreathing and rebreathing systems and fraction of inspired oxygen (fio2) of 0.9 and 0.4, respectively. methods: two groups of 10 dogs each under inhalation anesthesia with sevoflurane: gi in which it was utilized non-rebreathing semiclosed system and fio2 = 0.9, and gii in which it was utilized rebreathing semiclosed system and fio2 = 0.4. the study parameters were: heart rate, medium arterial pressure, right-to-left intrapulmonary shunt, hematocrit, hemoglobin, arterial partial pressure of oxygen, mixed venous partial pressure of oxygen, mixed venous oxygen saturation, arterial partial pressure of carbon dioxide, partial pressure of water in the alveoli. results: shunt results were significantly different between the two groups - gi data were higher than gii in all the evaluated moments. hence, the group with nonrebreathing (gi) developed a superior grade of intrapulmonary shunt when compared with the rebreathing group (gii). the partial pressure of water in the alveoli was significantly higher in gii. conclusion: the inhalation anesthesia with non-rebreathing system and fio2 = 0.9 developed a higher grade of intrapulmonary right-to-left shunt when compared with the rebreathing system and fio2 = 0.4. the higher humidity in gii contributed to the result.
Efeitos de concentra??es crescentes de lidocaína hiperbárica, administradas no espa?o subaracnóideo, sobre a medula espinhal e as meninges: estudo experimental em c?es
Pires, Silvania R.O.;Ganem, Eliana Marisa;Marques, Mariangela;Castiglia, Yara Marcondes Machado;
Revista Brasileira de Anestesiologia , 2006, DOI: 10.1590/S0034-70942006000300005
Abstract: background and objectives: lidocaine concentration potentially able to determine nervous tissue injury is still not well established. this study aimed at investigating the effect of increasing spinal lidocaine concentrations in single injection through quincke needle. methods: after the animal experiment ethical committee approval, 40 adult animals were anesthetized with fentanyl and etomidate and submitted to spinal puncture with 22g 21/2 quincke needle for the introduction of 1 ml of 7.5% glucose solution in 10 seconds - group 1; 5% lidocaine in 7.5% glucose solution - group 2; 7.5% lidocaine in 7.5% glucose solution - group 3; 10% lidocaine in 7.5% glucose solution - group 4. after intravenous anesthesia recovery and in the presence of spinal block, the following parameters were observed: presence of motor block, anal sphincter tone (normal or relaxed) and sensory block level in different cervical, thoracic, lumbar and sacral dermatomes. animals remained in captivity for 72 hours. anal sphincter tone, hind paws mobility, painful fore and hind paws and sacral, lumbar and thoracic dermatomes sensitivity were evaluated. were euthanized by electrocution under anesthesia and spinal cord and meningeal lumbar and sacral portions were removed for histological exam under optic microscopy. results: no group 1 and 2 animal presented clinical or histological injuries. three group 3 animals presented hind paws motor changes and anal sphincter relaxation with foci of posterior necrosis (two dogs) and fascial necrosis in all spinal cord surface (one dog). in a different animal of this group in which foci of necrosis were observed in less than 5% histological field, no clinical changes were found. seven group 4 animals presented clinical changes (paralysis or decreased muscle strength in hind paws, anal sphincter relaxation) or histological changes (spinal cord surface band necrosis or nervous tissue necrosis foci). conclusions: in this study, spinal lidocaine in concentrations
Complica??es neurológicas determinadas pela anestesia subaracnóidea
Ganem, Eliana Marisa;Castiglia, Yara Marcondes Machado;Vianna, Pedro Thadeu Galv?o;
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.
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