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Liga Acadêmica de Anestesiologia


Fundada em Agosto de 2016, com o objetivo de aprofundar os conhecimentos adquiridos na Faculdade a respeito da Anestesiologia e despertar o interesse pela especialidade, que ainda é pouco abordada durante o curso de Medicina – Clique na imagem para saber mais.

Clube de Benefícios do Associado

O Meu Orientador Virtual agora é parceiro da Sociedade de Anestesiologia de Minas Gerais.

O objetivo da parceria é auxiliar os membros da SAMG no desenvolvimento de seus projetos de pesquisa e artigos científicos, otimizando o tempo e garantindo maior eficiência e qualidade!

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Desconto especial de 15% para os membros associados da SAMG!

Última atualização 11/09/2019

Difficult airway management algorithms: a directed review.
Anaesthesia. 2019 Sep;74(9):1175-1185. doi: 10.1111/anae.14779.
Edelman DA, Perkins EJ, Brewster DJ.
The primary aim of this study was to identify, describe and compare the content of existing difficult airway management algorithms. Secondly, we aimed to describe the literature reporting the implementation of these algorithms. A directed search across three databases (MEDLINE, Embase and Scopus) was performed. All articles were screened for relevance to the research aims and according to pre-determined exclusion criteria. We identified 38 published airway management algorithms. Our results show that most facemask employ a four-step process as represented by a flow chart, with progression from tracheal intubation, facemask ventilation and supraglottic airway device use, to a rescue emergency surgical airway. The identified algorithms are overwhelmingly similar, yet many use differing terminology. The frequency of algorithm publication has increased recently, yet adherence and implementation outcome data remain limited. Our results highlight the lack of a single algorithm that is universally endorsed, recognised and applicable to all difficult airway management situations.

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International consensus statement on the use of uterotonic agents during caesarean section.
Anaesthesia. 2019 Oct;74(10):1305-1319. doi: 10.1111/anae.14757.
Heesen M, Carvalho B, Carvalho JCA, Duvekot JJ, Dyer RA, Lucas DN, McDonnell N, Orbach-Zinger S, Kinsella SM.
It is routine to give a uterotonic drug following delivery of the neonate during caesarean section. However, there is much heterogeneity in the relevant research, which has largely been performed in low-risk elective cases or women with uncomplicated labour. This is reflected in considerable variation in clinical practice. There are significant differences between dose requirements during elective and intrapartum caesarean section. Standard recommended doses are higher than required, with the potential for acute cardiovascular adverse effects. We recommend a small initial bolus dose of oxytocin, followed by a titrated infusion. The recommended doses of oxytocin may have to be increased in women with risk factors for uterine atony. Carbetocin at equipotent doses to oxytocin has similar actions, while avoiding the requirement for a continuous infusion after the initial dose and reducing the need for additional uterotonics. As with oxytocin, carbetocin dose requirements are higher for intrapartum caesarean sections. A second-line agent should be considered early if oxytocin/carbetocin fails to produce good uterine tone. Women with cardiac disease may be very sensitive to the adverse effects of oxytocin and other uterotonics, and their management needs to be individualised.

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A difficulty with the DIFFMASK score is the difficult statistics.
Anaesthesia. 2019 Oct;74(10):1337. doi: 10.1111/anae.14775.
O'Carroll JE, Wong DJN, Ahmad I.

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Revisiting the Classification of Neuromuscular Blockade, Aligning Clinical Practice and Research.
Anesth Analg. 2019 Sep 6. doi: 10.1213/ANE.0000000000004407.
Albers KI, Diaz-Cambronero O, Keijzer C, Snoeck MMJ, Warlé MC, Fuchs-Buder T.

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Characterisation and monitoring of postoperative respiratory depression: current approaches and future considerations.
Br J Anaesth. 2019 Sep;123(3):378-391. doi: 10.1016/j.bja.2019.05.044
Ayad S1, Khanna AK2, Iqbal SU3, Singla N4.
Respiratory depression is common in patients recovering from surgery and anaesthesia. Failure to recognise and lack of timely institution of intervention can lead to catastrophic cardiorespiratory arrest, anoxic brain injury, and mortality. Opioid-induced respiratory depression (OIRD) is a common and often under-diagnosed cause of postoperative respiratory depression. Other causes include residual anaesthesia, residual muscle paralysis, concurrent use of other sedatives, splinting from inadequate pain control, and obstructive sleep apnoea. Currently used methods to identify and monitor respiratory safety events in the post-surgical setting have serious limitations leading to lack of universal adoption. New tools and technologies currently under development are expected to improve the prediction of respiratory depression especially in patients requiring opioids to alleviate acute postoperative pain. In this narrative review, we discuss the various causes of postoperative respiratory depression, and highlight the advances in monitoring and early recognition of patients who develop this condition with an emphasis on OIRD.

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