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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
71

Efeitos de substituintes sobre a polaridade do grupo carbonila e a atividade anestésica local de N.N - [(dimetilamino) metil benzamidas para substituídas / Effect of substituents on carbonyl group polarity and local anesthetic activity of N,N-[(dimethyamine)methyl]benzhidrazides-para-substituted

Tavares, Leoberto Costa 22 December 1987 (has links)
Preparou-se, neste trabalho, nove cloridratos de N,N- [(dimetilamino)metil]benzamidas-p-X-substituidas em que X = N02, Br, Cl, I, F, H, CH3, OCH3 e N(CH3)2, SÉRIE II, ainda não descritos na literatura, a partir das respectivas bases, SÉRIE I. Os compostos obtidos foram identificados por seus espectros de I.V e RMN1H, e suas purezas determinadas por análise elementar e ponto de fusão. A seguir, determinou-se os valores de vC=O (cm-l ) em HCCl3, como medida de sua polaridade tanto para os compostos da SÉRIE I como para os da SÉRIE II. A aplicação da equação de HAMMETT, simples e expandida, aos valores obtidos forneceu excelentes correlações, verificando-se que os efeitos eletrônicos que os substituintes exercem sobre o grupo carbonila são de natureza indutiva e de ressonância, não havendo predominância de um sobre o outro. Determinou-se também, por bloqueio nervoso periférico em pata de rato, o grau de atividade anestésica local de sete dos nove compostos da SÉRIE II. A aplicação da equação de HANSCH aos valores de atividade anestésica local mostrou haver correlação razoável considerando-se os efeitos eletrônicos e hidrofóbicos exercidos pelos substituintes. A análise dos coeficientes de regressão obtidos sugere haver contribuição preponderante dos efeitos eletrônicos em relação à contribuição do efeito hidrofóbico para a atividade anestésica local. / In the present work nine N,N-[(dimethyl amino)methyl]benzamides-p-X-substituededs hydrochlorides (SERIES II) were prepared from the corresponding bases, (SERIES I), where X = N02, Br, Cl, I, F, H, CH3, OCH3 and N(CH3)3. The purity of the novel compounds, SERIES II, was established by elemental analysis. The recorded infrared and 1HNMR spectra were in agreement with their structures. For both sets of compounds the carbonyl group infrared frequencies in HCCl3 were determined and used as measurement of the polarity of the group. The obtained vC=O (cm-1) values showed excellent correlations when a simple or a multiparameter HAMMETT equation was applied. This suggests that the eletronic effect of the substituents on the carbonyl stretching frequencies is of inductive and ressonanee nature, without predominances of one over the other. Were also determined by peripheryc nervous blockade on rats paw, the degree of local anesthetic activity on seven of the nine compounds of SERIES II. The application of the HANSCH equation to the local anesthetie activity values showed reasonable correlation when the eletronic and hydrophobic effects of the substituents were considered. Analysis of the obtained regression coefficents suggest that the contribution of the former effect to the local anesthetic activity predominants.
72

Untersuchung der Erregbarkeit spinaler Motoneurone während Propofolmononarkosen

Müller, Katja 08 February 2006 (has links)
Einleitung: Zur Messung der Narkosetiefe standen bisher vor allem aus dem EEG abgeleitete Parameter im Mittelpunkt der Forschung, die sehr gut geeignet sind, die hypnotische Komponente der Anästhesie abzubilden. Eine Vorhersage auf motorische Reaktionen lassen sie jedoch nicht zu. Eine vorausgehende Studie hat gezeigt, dass unter Sevofluran der spinale H-Reflex mit der chirurgischen Immobilität korreliert. Die vorliegende Studie untersucht, ob motorische Reaktionen während Propofolmononarkosen mittels H-Reflex besser vorausgesagt werden können als mit den EEG-Parametern Bispektraler Index (BIS), spektrale Entropie (SE) und response Entropie (RE). Außerdem wurde der Einfluss von Propofol auf die Erholungskurve des H-Reflexes unter Doppelstimulation untersucht. Methodik: Nach Zustimmung der Ethikkommission und schriftlicher Einwilligung wurden 17 Patienten in die Studie eingeschlossen und ausgewertet. Nach der „up-and-down“-Methode von Dixon wurde die Konzentration von Propofol auf einen Wert eingestellt, bei dem die Hälfte der Patienten auf einen am Unterarm ausgelösten elektrischen Tetanus-Reiz (60 mA) mit einer gezielten motorischen Reaktion reagierten. Nach einer Kontrollmessung wurde die Konzentration von Propofol 15 min konstant gehalten. Danach wurde von einem „steady state“ ausgegangen und der Tetanusreiz wurde ausgelöst. Die Vorhersagefähigkeit der möglichen Narkosetiefe-parameter auf eine Bewegung wurde mit der „Prediction Probability“ (PK-Wert) ermittelt. Im zweiten Teil wurde der H-Reflex anhand der Doppelstimulation mit größer werdenden Interstimulusintervallen (50-8000 ms) untersucht. Ergebnisse: Die Wachwerte für die H-Reflexamplitude liegen bei 5,9 (± 3,8 SD) mV. Der von uns berechnete C50-Tetanus-Wert beträgt 4,5 ± 0,45 mg/l. Die PK-Werte 0,47 für den H-Reflex und 0,45 für die Herzfrequenz lassen nur zufällige Aussagen auf motorische Reaktionen zu. Die EEG-Parameter zeigen höhere PK-Werte: BIS (0,74), SE (0,73), RE (0,71). In diesem Bereich liegt auch der PK-Wert der Propofolzielkonzentration (0,76). Der Schmerzreiz beeinflusste weder die H-Reflexamplitude noch die EEG-Parameter. Bei der Doppelstimulation zeigte sich eine verzögerte Erholung des H-Reflexes unter Doppelstimulation, die am stärksten im Bereich der interkurrenten Fazilitation unter den Interstimulusabständen von 150 und 200 ms. Schlussfolgerung: Für die Vorhersage motorischer Reaktionen während Propofolmono-narkosen sind EEG-Parameter wie BIS, SE und RE etwas besser geeignet als der spinale H-Reflex. Dies steht im Gegensatz zu einer Untersuchung mit Sevofluran und wird auf die unterschiedlichen Wirkmechanismen von volatilen und intravenösen Anästhetika zurückgeführt. Die Unterdrückung der Erholungskurve des H-Reflexes unter Doppelstimula-tion, die vor allem im Bereich der interkurrenten Fazilitation stattfindet, ist möglicherweise durch eine Reduktion supraspinaler exzitatorischer Einflüsse zu erklären. / Introduction: The measurement of „depth of anaesthesia“ is mostly done by parameters of the electroencephalogram (EEG) which can predict hypnosis whereas the prediction of immobility is not possible with those parameters. A previous study has shown that the H-reflex amplitude can be used for monitoring of immobility during sevoflurane anaesthesia. This study examined whether the prediction of movement to painful stimulation is also possible during propofol anaesthesia on the basis of the H-reflex-amplitude compared with the EEG-parameters bispectral index (BIS), spectral entropy (SE) and response entropy (RE). Furthermore the influence of propofol on the H-reflex-recovery under double pulse stimulation was tested. Methods: After approval of the institutional review board and informed consent were obtained, 17 patients were included into this study. Using the “up-and down”-method the concentration of propofol was adjusted to the level where half of the patients do not move to painful stimulation (C50-tetanus-value). Propofol was administered after a baseline measurement. After at least 15 minutes of constant propofol concentration a "steady-state" was assumed and a painful electrical stimulation (tetanic stimulus of 60mA) was applied. To estimate and compare the predictive value of the parameters, prediction probability Pk was calculated. The H-reflex during double pulse stimulation was examined with interstimulus intervals ranging from 50 to 8000 ms. Results: At awake level, H-reflexes had a mean amplitude of 5.9 (+/- 3.8 SD) mV. The calculated C50-tetanus-value was 4.5 (+/- 0.45 SD) mg/l. With Pk-values of 0.47 for the H-reflex amplitude and 0.45 for the heart rate the prediction of movements is just by chance. The Pk-values of the EEG-parameters were higher: BIS (0.74), SE (0.73), RE (0.71). At this level was also the Pk-value of the propofol concentration (0.76). The painful stimulation influenced neither the H-reflex amplitude nor the EEG-parameters. The double pulse stimulation showed a delay in the H-reflex-recovery at interstimulus intervals of 150 and 200 ms. Conclusion: The prediction of movement during propofol anaesthesia is better using the EEG-parameters BIS, SE and RE compared to the H-reflex-amplitude. These results are in contrast to a previous study with sevoflurane which can be explained by the different molecular mechanisms of action of volatile and intravenous anaesthetics. The depression of the recovery-curve of the H-reflex under double pulse stimulation is possibly due to the reduction of supraspinal excitatory influences.
73

Avaliação comparativa da eficácia anestésica de 1,8mL e 3,6mL do cloridrato de articaina 4% com epinefrina 1:100.000 no bloqueio do nervo alveolar inferior e na injeção complementar no ligamento periodontal em pacientes com pulpite irreversível de molares mandibulares / Comparative evaluation of the anesthetic efficacy of 1.8mL and 3.6mL of 4% articaine hydrochloride with 1: 100,000 epinephrine in the inferior alveolar nerve block and in the complementary injection in the periodontal ligament in patients with irreversible mandibular molar pulpitis

Silva, Stella Agra da 17 February 2017 (has links)
O objetivo deste estudo foi comparar a eficácia anestésica de um volume de 1,8mL do cloridrato de articaína 4% com epinefrina 1:100.000 com um volume de 3,6mL do mesmo anestésico local no bloqueio convencional do nervo alveolar inferior (BNAI) e na injeção complementar no ligamento periodontal em pacientes com pulpite irreversível de molares mandibulares. Noventa pacientes do Setor de Urgência da Faculdade de Odontologia da Universidade de São Paulo receberam, aleatoriamente, 1 (1,8mL) ou 2 (3,6mL) tubetes da solução anestésica no BNAI. No caso de falha do BNAI, foram administrados os mesmos volumes pré-selecionados, aleatoriamente, na injeção complementar do ligamento periodontal. O sinal subjetivo de anestesia do lábio, a presença de anestesia pulpar e ausência de dor durante o procedimento de pulpectomia foram avaliados, respectivamente, por indagação ao paciente, por meio do aparelho estimulador pulpar elétrico e por uma escala analógica verbal. A análise estatística foi realizada por meio dos testes Qui-quadrado, Kruskal Wallis e Razão de Verossimilhancas. Após o BNAI, todos os pacientes reportaram anestesia no lábio. O volume de 1,8mL de articaína apresentou 27% de anestesia pulpar e o volume de 3,6mL apresentou 42%. A analgesia para o grupo de 1,8mL foi de 64% e para o volume de 3,6mL foi 73% após o BNAI, porém, essas diferenças não foram estatisticamente significantes. Na ocorrência da falha do BNAI, 64% dos pacientes sentiram dor na câmara pulpar, 32% em dentina e 4% no canal. Após a injeção no ligamento periodontal, o grupo de 1,8mL apresentou 75% de anestesia pulpar e o grupo de 3,6mL apresentou 42%. Em relação à analgesia durante o procedimento de pulpectomia, 31% dos pacientes do grupo de 1,8mL e 25% dos pacientes do grupo de 3,6mL apresentaram dor após a injeção no ligamento periodontal, porém, essas diferenças não foram estatisticamente significantes. Na ocorrência da falha da injeção do ligamento periodontal, 62% dos pacientes sentiram dor na câmara pulpar, 25% em dentina e 13% no canal. O aumento do volume de 1,8mL para 3,6mL da solução de articaína 4% com epinefrina 1:100.000 no BNAI e na injeção complementar no ligamento periodontal não aumentou significativamente a taxa de sucesso da anestesia pulpar e da analgesia. Portanto, os dois volumes anestésicos se comportam de forma semelhante, e não são efetivos no controle da dor durante o tratamento da pulpite irreversível de molares mandibulares.. / The aim of this study was to compare the anesthetic efficacy of a 1.8mL volume of 4% articaine hydrochloride with epinephrine 1:100,000 with a volume of 3.6mL of the same anesthetic in the inferior alveolar nerve block (BNAI) during pulpetcomy procedure in patients with irreversible pulpitis in mandibular molars. Ninety patients from the Emergency Department of the School of Dentistry of the University of São Paulo received randomly 1 (1.8mL) or 2 tubes (3.6mL) of the anesthetic solution in the BNAI. In the case of failure of the BNAI, the same pre-selected volumes were administered in the complementary injection of the periodontal ligament. The subjective signal of lip anesthesia, the presence of pulp anesthesia and absence of pain during pulpectomy were evaluated, respectively, by patient inquiry, through the electrical pulp stimulator and by an analogical verbal scale. Statistical analysis was performed using the Chi-square, Kruskal Wallis and Reason of Verossimilhancas tests. After the BNAI, all patients reported anesthesia on the lip. The volume of 1.8mL of articaine presented 27% of pulpal anesthesia and the volume of 3.6mL presented 42%. Analgesia for the 1.8mL group was 64% and for the volume of 3.6mL it was 73% after the BNAI, but these differences were not statistically significant. In the occurrence of BNAI failure, 64% of the patients felt pain in the pulp chamber, 32% in dentin and 4% in the root. After injection into the periodontal ligament, the 1.8mL group had 75% of pulpal anesthesia and the 3.6mL group had 42%. Regarding analgesia during the pulpectomy procedure, 31% of the patients in the 1.8mL group and 25% of the patients in the 3.6mL group had pain after injection into the periodontal ligament, but these differences were not statistically significant. In the occurrence of failure of the periodontal ligament injection, 62% of the patients felt pain in the pulp chamber, 25% in dentin and 13% in the root. Increasing the volume from 1.8mL to 3.6mL of the 4% articaine solution with 1: 100,000 epinephrine in the BNAI and in the complementary injection in the periodontal ligament did not significantly increase the success rate of pulpal anesthesia and analgesia. Therefore, both anesthetic volumes behave similarly, and are not effective in controlling pain in the treatment of irreversible mandibular molar pulpitis.
74

Efeitos de substituintes sobre a polaridade do grupo carbonila e a atividade anestésica local de N.N - [(dimetilamino) metil benzamidas para substituídas / Effect of substituents on carbonyl group polarity and local anesthetic activity of N,N-[(dimethyamine)methyl]benzhidrazides-para-substituted

Leoberto Costa Tavares 22 December 1987 (has links)
Preparou-se, neste trabalho, nove cloridratos de N,N- [(dimetilamino)metil]benzamidas-p-X-substituidas em que X = N02, Br, Cl, I, F, H, CH3, OCH3 e N(CH3)2, SÉRIE II, ainda não descritos na literatura, a partir das respectivas bases, SÉRIE I. Os compostos obtidos foram identificados por seus espectros de I.V e RMN1H, e suas purezas determinadas por análise elementar e ponto de fusão. A seguir, determinou-se os valores de vC=O (cm-l ) em HCCl3, como medida de sua polaridade tanto para os compostos da SÉRIE I como para os da SÉRIE II. A aplicação da equação de HAMMETT, simples e expandida, aos valores obtidos forneceu excelentes correlações, verificando-se que os efeitos eletrônicos que os substituintes exercem sobre o grupo carbonila são de natureza indutiva e de ressonância, não havendo predominância de um sobre o outro. Determinou-se também, por bloqueio nervoso periférico em pata de rato, o grau de atividade anestésica local de sete dos nove compostos da SÉRIE II. A aplicação da equação de HANSCH aos valores de atividade anestésica local mostrou haver correlação razoável considerando-se os efeitos eletrônicos e hidrofóbicos exercidos pelos substituintes. A análise dos coeficientes de regressão obtidos sugere haver contribuição preponderante dos efeitos eletrônicos em relação à contribuição do efeito hidrofóbico para a atividade anestésica local. / In the present work nine N,N-[(dimethyl amino)methyl]benzamides-p-X-substituededs hydrochlorides (SERIES II) were prepared from the corresponding bases, (SERIES I), where X = N02, Br, Cl, I, F, H, CH3, OCH3 and N(CH3)3. The purity of the novel compounds, SERIES II, was established by elemental analysis. The recorded infrared and 1HNMR spectra were in agreement with their structures. For both sets of compounds the carbonyl group infrared frequencies in HCCl3 were determined and used as measurement of the polarity of the group. The obtained vC=O (cm-1) values showed excellent correlations when a simple or a multiparameter HAMMETT equation was applied. This suggests that the eletronic effect of the substituents on the carbonyl stretching frequencies is of inductive and ressonanee nature, without predominances of one over the other. Were also determined by peripheryc nervous blockade on rats paw, the degree of local anesthetic activity on seven of the nine compounds of SERIES II. The application of the HANSCH equation to the local anesthetie activity values showed reasonable correlation when the eletronic and hydrophobic effects of the substituents were considered. Analysis of the obtained regression coefficents suggest that the contribution of the former effect to the local anesthetic activity predominants.
75

Isofluran oder Sevofluran zur Sedierung von beatmeten Patienten in der Intensivmedizin: Abhängigkeit der Leistungsfähigkeit des MIRUS-Applikationssystems von den Beatmungsparametern im Lungenmodell und im klinischen Kontext unter besonderer Berücksichtigung ökonomischer Aspekte / Isoflurane or Sevoflurane for sedation of ventilated patients at the intensive care unit: Dependence of the capacity of the MIRUS-applicationsystem on ventilation parameters in a lung model and under clinical conditions with special attention to economic aspects.

Schröder, Alexandra 01 April 2019 (has links)
No description available.
76

Anestesia paravertebral torácica em cães / Thoracic paravertebral block in dogs

Villela, Ana Carolina Vasques 18 March 2016 (has links)
Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2016-08-09T18:49:21Z No. of bitstreams: 2 Tese - Ana Carolina Vasques Villela - 2016.pdf: 1850105 bytes, checksum: b1e0b35f32407fbefabe7f26e02c3604 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-10T11:48:54Z (GMT) No. of bitstreams: 2 Tese - Ana Carolina Vasques Villela - 2016.pdf: 1850105 bytes, checksum: b1e0b35f32407fbefabe7f26e02c3604 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-10T11:48:54Z (GMT). No. of bitstreams: 2 Tese - Ana Carolina Vasques Villela - 2016.pdf: 1850105 bytes, checksum: b1e0b35f32407fbefabe7f26e02c3604 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-03-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Thoracic paravertebral block (TPB) is a regional anesthesia technique which provides anesthesia and analgesia with hemodynamic stability, low incidence of complications and few contraindications. However, some techniques are still poorly studied in veterinary medicine due to difficulty in accessing specific nerves. The present study aimed at reviewing the thoracic anatomy, where TPB was conducted, determining values between reference points in order to implement this technique, assessing blockade’s quality and hemodynamic effects resulting from 2.5 mg/kg of bupivacaine 0.5% administration in dogs’ paravertebral space. Initially, structures involved when performing TPB were identified during an anatomical study in cadavers. In the second stage, eight healthy male or female dogs, mixed-breed, weighing 16.33 ± 4.04 kg, were submitted to TPB under general anesthesia with isoflurane. The blockage of thoracic T5, T6 and T7 nerves was performed with 2.5 mg/kg of bupivacaine 0.5%, guided by a neuro stimulator. Subsequently, the animals were anesthetized following the same protocol used in the previous stage for pulmonary-artery catheterization via the femoral vein, in order to assess hemodynamic effects of TPB. During TPB performance, the distances between the skin and the transverse process of thoracic vertebrae (STD) as well as the skin and paravertebral space (SPD) were obtained. Isoflurane supply was discontinued and analgesia evaluation was performed by pinprick test and hemostat pressure in conscious animals, after anesthesia recover. During hemodynamic evaluations the animals were kept anesthetized under spontaneous ventilation, while central venous pressure (CVP), cardiac output (CO), pulmonary artery pressure (PAP), pulmonary artery occlusion pressure (PAOP) and other cardiovascular variables were measured. Arterial and mixed venous blood were collected for blood gas analysis such as pH, oxygen partial pressure (PO2), carbon dioxide partial pressure (PCO2), bicarbonate (HCO3-), base excess (BE), anion gap (AG) and electrolytes such as sodium (Na+), potassium (K+), calcium (Ca2+) and chloride (Cl-), tissue oxygenation variables such as oxygen delivery (DO2), consumption (VO2) and oxygen extraction (OEF) were also calculated. Evaluations were made just before TPB (T0) and every 20 minutes in the next 80 minutes (T20, T40, T60, T80). Anatomical study revealed that some thoracic muscles’ innervation come from the brachial plexus. The average obtained for STD was 3.81 ± 1.07 cm and for SPD was 6.25 ± 0.93 cm. The anesthetic block was observed in 3.63±2.77 dermatomes during 250.25 ± 44.02 minutes. The variables CVP, CO, PAP, PAOP, DO2, OEF and PO2 in mixed-venous blood, increased significantly after bupivacaine administration. Similarly, PO2 from mixed venous blood as well as DO2 and OEF increased significantly during hemodynamic evaluations. TPB provided anesthesia in a limited region of the chest wall with clinically irrelevant hemodynamic effects, however this technique did not satisfactorily anesthetized all thoracic muscles’ layers so it should be used in combination with general anesthesia. / O bloqueio paravertebral torácico (BPT) é uma técnica de anestesia locorregional que fornece anestesia/analgesia no local da cirurgia com estabilidade hemodinâmica, baixa incidência de complicações e poucas contraindicações. No entanto, esta ferramenta ainda é pouco estudada na medicina veterinária devido à dificuldade de acesso aos nervos a serem bloqueados. O objetivo deste estudo foi rever a anatomia da região envolvida na realização do BPT, determinar as medidas entre os pontos de referência para execução desta técnica anestésica e avaliar a qualidade do bloqueio e as alterações hemodinâmicas decorrentes da administração de 2,5 mg/kg de bupivacaína a 0,5% no espaço paravertebral torácico de cães. Inicialmente, foi feito um estudo anatômico em cadáveres para identificar as estruturas envolvidas na execução do BPT. Na segunda etapa do estudo, oito cães saudáveis machos ou fêmeas, SRD, pesando 16,33 ± 4,04 kg, foram submetidos a anestesia geral com isofluorano para realização do BPT. O bloqueio dos nervos torácicos T5. T6 e T7 foi feito com 2,5 mg/kg de bupivacaína a 0,5%, com o auxílio de um neuroestimulador. Na terceira etapa, os mesmos animais foram anestesiados com isofluorano e, após introdução de um cateter de artéria pulmonar pela veia femoral, os animais foram submetidos ao BPT com 2,5 mg/kg de bupivacaína a 0,5% para avaliação das possíveis alterações hemodinâmicas. Foram obtidas as distâncias entre a pele e o processo transverso (DPt) e entre a pele e o espaço paravertebral torácico (DEp). Em seguida o fornecimento de isofluorano foi interrompido e a avaliação da analgesia foi realizada pelo pinçamento da pele com pinça hemostática. Para as avaliações hemodinâmicas os animais foram mantidos anestesiados com isofluorano sob ventilação espontânea e foram mensurados a pressão venosa central, (PVC), o débito cardíaco (DC), a pressão da artéria pulmonar (PAP) e a pressão da artéria pulmonar ocluída (PAPo), além de outras variáveis cardiovasculares indiretas calculadas. O sangue arterial e venoso misto foi coletado para avaliação do pH, pressão parcial de oxigênio (PaO2) e de dióxido de carbono (PCO2), bicarbonato (HCO3-), excesso de base (BE), ânion GAP (AG), eletrólitos sódio (Na+), potássio (K+), cálcio (Ca2+) e cloro (Cl-) e das variáveis de oxigenação tecidual como oferta (DO2), o consumo (VO2) e a extração de oxigênio (ERO2). As avaliações foram feitas imediatamente antes do BPT (T0) e, posteriormente, a cada 20 minutos (T20, T40, T60, T80). O estudo anatômico revelou que a inervação de alguns músculos da parede torácica é proveniente do plexo braquial. A DPt média foi de 3,81 ± 1,07 cm e a DEp média de 6,25 ± 0,93 cm. O bloqueio anestésico foi observado em 3,63 ± 2,77 dermátomos durante 250,25 ± 44,02 minutos. A PVC, o DC, a PAP e PAPo, a DO2, a ERO2 e a PaO2 no sangue venoso misto aumentaram significativamente após a administração da bupivacaína. O BPT promove anestesia em uma região limitada da parede torácica com alterações hemodinâmicas sem significância clínica, mas pode não anestesiar de forma satisfatória todas as camadas musculares da parede torácica, devendo ser utilizado em associação com a anestesia geral.
77

Caracterização, resfriamento e criopreservação de sêmen de tilápia-do-nilo cultivada no estado do Ceará / Characterization, and cooling cryopreservation semen of nile tilapia-of-the state of cultivated Ceará

Teixeira, Erivânia Gomes January 2013 (has links)
TEIXEIRA, Erivânia Gomes. Caracterização, resfriamento e criopreservação de sêmen de tilápia-do-nilo cultivada no estado do Ceará. 2013. 92 f. : Tese (doutorado) - Universidade Federal do Ceará, Centro de Ciências Agrárias, Departamento de Engenharia de Pesca, Fortaleza-CE, 20113 / Submitted by Nádja Goes (nmoraissoares@gmail.com) on 2016-07-26T12:26:41Z No. of bitstreams: 1 2013_tese_egteixeira.pdf: 1255411 bytes, checksum: 260b5caf7b5bf38819e087108c82096e (MD5) / Approved for entry into archive by Nádja Goes (nmoraissoares@gmail.com) on 2016-07-26T12:26:56Z (GMT) No. of bitstreams: 1 2013_tese_egteixeira.pdf: 1255411 bytes, checksum: 260b5caf7b5bf38819e087108c82096e (MD5) / Made available in DSpace on 2016-07-26T12:26:56Z (GMT). No. of bitstreams: 1 2013_tese_egteixeira.pdf: 1255411 bytes, checksum: 260b5caf7b5bf38819e087108c82096e (MD5) Previous issue date: 2013 / The present study deals with anesthetic induction, characterization of sperm fluid, cooling and freezing of sperm of the Nile tilapia Oreochromis niloticus. In the first chapter the natural anesthetics menthol and eugenol were tested in adult specimens aiming to determine the ideal concentration for handling the Nile tilapia. In the second chapter the sperm fluid of the Nile tilapia was characterized according to the following parameters: collected volume, which showed the feasibility of collect in sufficient volume without the need of sacrificing the fish; sperm concentration, which showed significant variation between specimens; pH and osmolarity, which confirm the information of the literature; sperm motility time, which proved that the spermatozoa of tilapia are differentiated concerning accumulated energy when compared to other freshwater species; and sperm head morphometry, characterized by size (length, width, perimeter and area) and head shape (ellipticity, rugosity, elongation and regularity). In the third chapter we evaluated the feasibility of preservation of tilapia sperm using different extenders and cooled at 4°C. The sperm motility rate was evaluated with the aid of the Computer-assisted Sperm Analyzer (CASA) System. In this, the ACP-104, media based on powdered coconut water, showed best sperm motility rate for up to 72 hours after storage. In the fourth chapter was evaluated the effects of different cryoprotectants on the post-thaw Nile tilapia sperm, using the software Sperm Class Analyzer (SCA). The results of the sperm motility rate and sperm velocity parameters revealed that ACP-104 in combination with dimethylsulfoxide is a promising cryodiluent for Nile tilapia sperm in long-term conservation. / O estudo trata da indução anestésica, caracterização do líquido seminal, refrigeração e congelação do sêmen de tilápia-do-Nilo, Oreochromis niloticus. No primeiro capítulo foram testados os anestésicos naturais mentol e eugenol em espécimes adultos objetivando determinar a concentração ideal para manejo de tilápia-do-Nilo. No segundo capítulo, o líquido seminal da tilápia-do-Nilo foi caracterizado de acordo com os seguintes parâmetros: volume coletado, que revelou a viabilidade de coleta em volumes suficientes, sem a necessidade de sacrificar o peixe; concentração espermática, que mostrou relevante variação entre espécimes; pH e osmolaridade, que ratificam as informações presentes na literatura; tempo de motilidade, que comprovou ser o espermatozoide de tilápia diferenciado quanto à energia acumulada quando comparado a outras espécies de água doce; e morfometria da cabeça do espermatozoide por meio das seguintes medidas: comprimento, largura, perímetro e área. Também foram registrados quatro parâmetros derivados do formato da cabeça: elipticidade, rugosidade, elongação e regularidade. No terceiro capítulo foi avaliada a viabilidade do sêmen de tilápia-do-Nilo submetido a diferentes diluentes e refrigerado a 4°C. A avaliação foi realizada por meio da taxa de motilidade espermática determinada pelo sistema CASA (Computer Assisted Sperm Analysis). Neste, o ACP-104, diluente à base de água de coco em pó, ofereceu melhor taxa de motilidade dos espermatozoides por até 72 horas de estocagem. Esta resposta mostrou que o ACP-104 é um diluente promissor para o sêmen da referida espécie. No quarto capítulo foi avaliado o efeito de diferentes criodiluentes sobre do sêmen de tilápia-do-Nilo pós-descongelação, utilizando o software (Sperm Class Analyser, SCA). Os resultados de motilidade espermática e de parâmetros de velocidade do espermatozoide revelaram que o ACP-104 combinado ao dimetilsulfóxido apresenta-se como um criodiluente promissor para a criopreservação do sêmen de tilápia-do-Nilo em longo prazo.
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Specifika ošetřovatelské péče u pacienta s MRSA na operačním sále z pohledu anesteziologické sestry / Specifics of nurse care at the patient with MRSA on surgery from nurses' point of view.

KALÁBOVÁ, Miroslava January 2010 (has links)
Title of the thesis: Specifics of the nursing care of patients with MRSA in the operating room from an anesthesiology nurse perspective. The aim of this thesis was to identify the specifics of nursing care of a patient with the MRSA in the operating room from the perspective of nurses working in the operating room. In the theoretical part focus is given to nursing care and its specifics for a patient with MRSA. Chapters relating to the regime measures, barrier nursing procedures and the use of specific aids, instruments and tools are treated in detail. The nursing care provided by anesthesia nurses and perioperative nurses in the operating room is defined. To reach the goals the quantitative research through questionnaires was chosen. The research sample consisted of anesthesia nurses and perioperative care nurses. Two types of standardized questionnaires were used, consisted of closed questions where respondents chose an appropriate answer, and from semi-open questions where respondents could specify their answers, and in one case open questions. Both questionnaires were completed by 12 test questions, where respondents had the choice of three possible answers, where one answer was correct. The results of the investigation are summarized in two types of graphs. Bar charts were used in questions where more answers were possible to mark, and for a better clarity the results were supplemented by tables. Results to other questions, where options were limited by one answer, are shown in percentages in pie graphs. Our thesis is very narrowly focused, because we concentrated on specifics of nursing care in a patient with MRSA in the operating room. We have determined the specifics of barrier nursing, nursing problems in a patient with MRSA in the operating room. We have discovered barrier nursing procedures in a patient with MRSA in the operating room. We have also succeeded in assessing the knowledge of nurses working in the operating room. The goal was met. An interesting finding was that most of anesthetic nurses and perioperative nurses had responded that the structural and technical arrangement in the operating room was not satisfactory in terms of barrier nursing of a patient with MRSA. This problem was expected, owing to the author´s experience in operating theaters. Thus Hypothesis 1 is confirmed. In total five hypotheses were stated, four of which were confirmed and one was disproved. The aim of the thesis was to draw attention to problems in the operating room during nursing a patient with MRSA. In the course of the research work there were no problems, however, it is necessary to mention the lack of literature on MRSA with regard to nursing care in operating theaters. The theoretical section of this thesis could be recommended as a resource for the education plan created on the basis of information collected and the results of this research. The results of the research survey may serve for general public, anesthesia and perioperative nurses who could benefit from the educational plan in practice while providing nursing care for a patient with MRSA.
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Avaliação comparativa da eficácia anestésica de 1,8mL e 3,6mL do cloridrato de articaina 4% com epinefrina 1:100.000 no bloqueio do nervo alveolar inferior e na injeção complementar no ligamento periodontal em pacientes com pulpite irreversível de molares mandibulares / Comparative evaluation of the anesthetic efficacy of 1.8mL and 3.6mL of 4% articaine hydrochloride with 1: 100,000 epinephrine in the inferior alveolar nerve block and in the complementary injection in the periodontal ligament in patients with irreversible mandibular molar pulpitis

Stella Agra da Silva 17 February 2017 (has links)
O objetivo deste estudo foi comparar a eficácia anestésica de um volume de 1,8mL do cloridrato de articaína 4% com epinefrina 1:100.000 com um volume de 3,6mL do mesmo anestésico local no bloqueio convencional do nervo alveolar inferior (BNAI) e na injeção complementar no ligamento periodontal em pacientes com pulpite irreversível de molares mandibulares. Noventa pacientes do Setor de Urgência da Faculdade de Odontologia da Universidade de São Paulo receberam, aleatoriamente, 1 (1,8mL) ou 2 (3,6mL) tubetes da solução anestésica no BNAI. No caso de falha do BNAI, foram administrados os mesmos volumes pré-selecionados, aleatoriamente, na injeção complementar do ligamento periodontal. O sinal subjetivo de anestesia do lábio, a presença de anestesia pulpar e ausência de dor durante o procedimento de pulpectomia foram avaliados, respectivamente, por indagação ao paciente, por meio do aparelho estimulador pulpar elétrico e por uma escala analógica verbal. A análise estatística foi realizada por meio dos testes Qui-quadrado, Kruskal Wallis e Razão de Verossimilhancas. Após o BNAI, todos os pacientes reportaram anestesia no lábio. O volume de 1,8mL de articaína apresentou 27% de anestesia pulpar e o volume de 3,6mL apresentou 42%. A analgesia para o grupo de 1,8mL foi de 64% e para o volume de 3,6mL foi 73% após o BNAI, porém, essas diferenças não foram estatisticamente significantes. Na ocorrência da falha do BNAI, 64% dos pacientes sentiram dor na câmara pulpar, 32% em dentina e 4% no canal. Após a injeção no ligamento periodontal, o grupo de 1,8mL apresentou 75% de anestesia pulpar e o grupo de 3,6mL apresentou 42%. Em relação à analgesia durante o procedimento de pulpectomia, 31% dos pacientes do grupo de 1,8mL e 25% dos pacientes do grupo de 3,6mL apresentaram dor após a injeção no ligamento periodontal, porém, essas diferenças não foram estatisticamente significantes. Na ocorrência da falha da injeção do ligamento periodontal, 62% dos pacientes sentiram dor na câmara pulpar, 25% em dentina e 13% no canal. O aumento do volume de 1,8mL para 3,6mL da solução de articaína 4% com epinefrina 1:100.000 no BNAI e na injeção complementar no ligamento periodontal não aumentou significativamente a taxa de sucesso da anestesia pulpar e da analgesia. Portanto, os dois volumes anestésicos se comportam de forma semelhante, e não são efetivos no controle da dor durante o tratamento da pulpite irreversível de molares mandibulares.. / The aim of this study was to compare the anesthetic efficacy of a 1.8mL volume of 4% articaine hydrochloride with epinephrine 1:100,000 with a volume of 3.6mL of the same anesthetic in the inferior alveolar nerve block (BNAI) during pulpetcomy procedure in patients with irreversible pulpitis in mandibular molars. Ninety patients from the Emergency Department of the School of Dentistry of the University of São Paulo received randomly 1 (1.8mL) or 2 tubes (3.6mL) of the anesthetic solution in the BNAI. In the case of failure of the BNAI, the same pre-selected volumes were administered in the complementary injection of the periodontal ligament. The subjective signal of lip anesthesia, the presence of pulp anesthesia and absence of pain during pulpectomy were evaluated, respectively, by patient inquiry, through the electrical pulp stimulator and by an analogical verbal scale. Statistical analysis was performed using the Chi-square, Kruskal Wallis and Reason of Verossimilhancas tests. After the BNAI, all patients reported anesthesia on the lip. The volume of 1.8mL of articaine presented 27% of pulpal anesthesia and the volume of 3.6mL presented 42%. Analgesia for the 1.8mL group was 64% and for the volume of 3.6mL it was 73% after the BNAI, but these differences were not statistically significant. In the occurrence of BNAI failure, 64% of the patients felt pain in the pulp chamber, 32% in dentin and 4% in the root. After injection into the periodontal ligament, the 1.8mL group had 75% of pulpal anesthesia and the 3.6mL group had 42%. Regarding analgesia during the pulpectomy procedure, 31% of the patients in the 1.8mL group and 25% of the patients in the 3.6mL group had pain after injection into the periodontal ligament, but these differences were not statistically significant. In the occurrence of failure of the periodontal ligament injection, 62% of the patients felt pain in the pulp chamber, 25% in dentin and 13% in the root. Increasing the volume from 1.8mL to 3.6mL of the 4% articaine solution with 1: 100,000 epinephrine in the BNAI and in the complementary injection in the periodontal ligament did not significantly increase the success rate of pulpal anesthesia and analgesia. Therefore, both anesthetic volumes behave similarly, and are not effective in controlling pain in the treatment of irreversible mandibular molar pulpitis.
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Plano de carreira e remuneração em grupos de anestesia da região Sul do Brasil

Santos, Miguel Leonardo Schmiedel dos 06 1900 (has links)
Submitted by Miguel Leonardo Schmiedel dos Santos (dr-miguel@hotmail.com) on 2018-06-16T22:32:01Z No. of bitstreams: 1 TA MiguelLSS versão final 150618.pdf: 557595 bytes, checksum: 06c83c8890bd5b49972d11f9f2491619 (MD5) / Rejected by Simone de Andrade Lopes Pires (simone.lopes@fgv.br), reason: Prezado Miguel, Recebemos a postagem do seu trabalho na biblioteca digital e para ser aprovado serão necessários 1 ajuste: 1º - NOME DA ESCOLA: FUNDAÇÃO GETULIO VARGAS, não tem acento no "U" Atenciosamente, Simone de A Lopes Pires SRA on 2018-06-18T17:12:14Z (GMT) / Submitted by Miguel Leonardo Schmiedel dos Santos (dr-miguel@hotmail.com) on 2018-06-18T22:03:36Z No. of bitstreams: 1 TA MiguelLSS versão final 150618 corrig acento.pdf: 556746 bytes, checksum: 2e0cdd75d53a985797edbf9869b657ec (MD5) / Approved for entry into archive by Simone de Andrade Lopes Pires (simone.lopes@fgv.br) on 2018-06-19T00:28:22Z (GMT) No. of bitstreams: 1 TA MiguelLSS versão final 150618 corrig acento.pdf: 556746 bytes, checksum: 2e0cdd75d53a985797edbf9869b657ec (MD5) / Approved for entry into archive by Isabele Garcia (isabele.garcia@fgv.br) on 2018-06-19T16:28:33Z (GMT) No. of bitstreams: 1 TA MiguelLSS versão final 150618 corrig acento.pdf: 556746 bytes, checksum: 2e0cdd75d53a985797edbf9869b657ec (MD5) / Made available in DSpace on 2018-06-19T16:28:33Z (GMT). No. of bitstreams: 1 TA MiguelLSS versão final 150618 corrig acento.pdf: 556746 bytes, checksum: 2e0cdd75d53a985797edbf9869b657ec (MD5) Previous issue date: 2018 / Em um ambiente de negócios engessado pela rigidez da legislação trabalhista brasileira, a remuneração é fator central tanto na atração quanto na retenção de bons profissionais. Passando pela questão motivacional, o plano de carreira e a remuneração são assuntos vigentes na pauta dos gestores de todos os setores, inclusive no setor saúde. Uma das bandeiras dos sindicatos, das associações e dos conselhos de medicina em todo o país, a carreira e a remuneração médicas ainda são assuntos que estão longe de um consenso e do esgotamento. Este trabalho aplicado tem por objetivos analisar a carreira e a remuneração médica operacionalizada por grupos (empresas) de anestesia selecionados, da região sul do Brasil. Discute-se, no presente trabalho, modelo de organização em empresas compostas por médicos, plano de carreira médica, remuneração médica e benefícios através dos modelos observados em três diferentes organizações de anestesistas, comparando-os entre si e com os modelos tradicionais. Os modelos estudados divergem dos métodos de contratação ou de prestação de serviço tradicionais na área de saúde, sejam públicos, sejam privados, através da oferta de benefícios financeiros e fatores remuneratórios híbridos quando comparados aos modelos tradicionais de remuneração, além de apresentar estrutura clara e delineada sobre a progressão na carreira para seus membros. O estudo destes modelos busca lançar luz sobre modelos não tradicionais de organização e estruturação da carreira e da remuneração médica, visando contemplar os interesses organizacionais e individuais, oferecendo outra alternativa de solução para questões nevrálgicas da atualidade médica. / At a business environment which is restricted by the inflexibility of the Brazilian labor legislation, remuneration is a central factor as much for attracting as for retaining qualified professionals. As for motivational matters, career planning and remuneration are issues which are currently being dealt with among managing teams of all divisions, including the health division. Despite the fact that medical career and remuneration are some of the topics which are widely discussed by medical unions, associations and councils throughout the entire country, it will be a long before reaching a common ground and exhausting the subject. This study aims at analyzing the medical career and remuneration of some selected anesthetic groups (companies) in the South of Brazil. It is discussed, in the present paper, the model of organization of companies composed by doctors, medical career planning, medical remuneration and benefits, comparing the observed models of three different anesthetist’s organization. The models were compared with each other and also with traditional models. The analyzed models differ from the regular hiring and service supplying models in the health department (be it public or private), providing financial benefits and hybrid remuneration factors when compared to the more traditional ones. Besides, they seem to illustrate a clear and well-designed career plan for its members. The study of these models intends to cast a light over the non-traditional models of career organizing and building as well as the medical remuneration, aiming at accounting for individual and organizational interests. The study offers alternative for solving crucial matters of the present medical situation.

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