SUMMARY OBJECTIVE: The aim of the study was to compare the postoperative effects of endotracheal tube cuff inflation with alkalized lidocaine in patients undergoing thyroidectomy surgery. METHODS: This is a randomized, double-blind clinical trial between August 2020 and August 2022 at the Hospital São Domingos, São Luís, Maranhão, Brazil. Patients over 18 years who underwent thyroidectomy of both sexes, American Society of Anesthesiologists (ASA) I or ASA II, were included. Patients with difficult orotracheal intubation, smoking, cuff rupture during orotracheal intubation, heart, lung, or neuropathies, previous surgery of the larynx or trachea, with risk of aspiration of gastric contents, or with the need to use a nasogastric tube were excluded. Patients were randomly selected and divided into the control group, whose cuff was filled with 0.9% saline solution, and the alkalinized lidocaine group, where the cuff was filled with 2% lidocaine and 8.4% sodium bicarbonate. RESULTS: The control group had higher systolic blood pressure [137 (94–183) mmHg] medians after extubation than the alkalinized lidocaine group [127 (82–189) mmHg] (p=0.03). The same was observed in heart rate values [control group: 86 (62–120); alkalinized lidocaine group: 80 (53–120)] (p=0.034). The alkalinized lidocaine group showed a significant increase in the ability to sustain phonation in the 24 h postoperatively, from 82.0 to 98.0% (p=0.031). CONCLUSION: There was no protective effect of the use of alkalinized lidocaine on the sensation of swallowing and complaints after thyroidectomy surgery. There was a significant improvement in hemodynamic response in the intervention group after extubation. OBJECTIVE METHODS randomized doubleblind double blind 202 Domingos Luís Maranhão Brazil 1 sexes (ASA II included intubation smoking lung neuropathies trachea contents excluded 09 0 9 0.9 solution 2 84 8 4 8.4 bicarbonate RESULTS 137 [13 94–183 94183 94 183 (94–183 mmHg 127 [12 82–189 82189 82 189 (82–189 p=0.03. p003 p p=0.03 . 03 (p=0.03) 62–120 62120 62 120 (62–120) 53–120 53120 53 (53–120) p=0.034. p0034 p=0.034 034 (p=0.034) postoperatively 820 82. 980 98 98.0 p=0.031. p0031 p=0.031 031 (p=0.031) CONCLUSION 20 0. 8. 13 [1 94–18 9418 (94–18 12 82–18 8218 (82–18 p00 p=0.0 (p=0.03 62–12 6212 6 (62–120 53–12 5312 5 (53–120 (p=0.034 98. (p=0.031 [ 94–1 941 (94–1 82–1 821 (82–1 p0 p=0. (p=0.0 62–1 621 (62–12 53–1 531 (53–12 94– (94– 82– (82– p=0 (p=0. 62– (62–1 53– (53–1 (94 (82 p= (p=0 (62– (53– (9 (8 (p= (62 (53 ( (p (6 (5

SUMMARY OBJECTIVE: Therapy and vocal rehabilitation in laryngeal cancer impact patients’ quality of life. The objective of this study was to evaluate the evolution of the quality of life of patients with laryngeal cancer submitted to total laryngectomy and using electrolarynx. METHODS: This is an observational study with a cross-sectional design and a quantitative approach. It was conducted between April 2022 and January 2023 in a Brazilian cancer hospital. For data collection, a quality of life questionnaire, validated for patients with head and neck cancer at the University of Washington, was applied in two phases: from 7 days after total laryngectomy and, subsequently, from 70 days after surgery using electronic larynx for at least 60 days. The inclusion criteria were patients undergoing total laryngectomy included on the Aldenora Bello Cancer Hospital's election list to receive the electronic larynx. Patients who did not sign the informed consent form were not included. RESULTS: The sample consisted of 31 patients, of which approximately 84% were men and approximately 93% at the age of 50 years or older. When comparing the phases, it is possible to observe that the item speech had the greatest progress, while chewing had the least. Only the item recreation, swallowing, taste, and saliva did not show any statistical significance. The score for the general quality of life questions increased. CONCLUSION: Electronic larynx is a viable and useful method of voice rehabilitation. Our data suggest that the use of the electrolarynx as a postlaryngectomy method of verbal communication is responsible for positive effects on patients’ quality of life. OBJECTIVE METHODS crosssectional cross sectional approach 202 hospital collection questionnaire Washington phases subsequently 6 Hospitals Hospital s RESULTS 3 84 93 5 older progress recreation swallowing taste significance increased CONCLUSION 20 8 9 2

SUMMARY OBJECTIVE: The aim of the study was to evaluate the impact of laparoscopic surgical treatment of endometriosis on the levels of health-related depression in patients using a validated questionnaire. METHODS: A prospective study was carried out between September 2020 and May 2022 in a private hospital (São Luís, Maranhão, Brazil), which analysed depression using the Beck Depression Inventory-II, on 103 patients undergoing surgical treatment for endometriosis, evaluated preoperatively and 3 and 6 months after the procedure. Patients with unsuccessful clinical treatment for endometriosis and pain level ≥7 on Visual Analog Scale and who agreed to participate in the study were included. Demographic data were acquired by consulting medical records. RESULTS: The average age of the participants was 36±6.3 years; the majority of patients were brown (68.6%), married (66.6%), overweight (55.8%), had had hormonal treatments with progestogens (50.9%), low fertility (50.9%), severe endometriosis (39.3%), endometriosis surgery+myomectomy (29.4%) and one (1%) patient withdrew from the study. There was a statistically significant reduction in mean Beck Depression Inventory between the preoperative period and 6 months after surgery (p<0.0001). CONCLUSION: Surgical treatment of endometriosis appears to have a positive impact on the symptoms of depression in the patients evaluated. OBJECTIVE healthrelated health related questionnaire METHODS 202 São Luís Maranhão Brazil, Brazil , Brazil) InventoryII, InventoryII II, II Inventory-II 10 procedure 7 ≥ included records RESULTS 3663 36 36±6. years 68.6%, 686 68.6% 68 (68.6%) 66.6%, 666 66.6% 66 (66.6%) 55.8%, 558 55.8% 55 8 (55.8%) 50.9%, 509 50.9% 50 9 (50.9%) 39.3%, 393 39.3% 39 (39.3%) surgerymyomectomy myomectomy 29.4% 294 29 4 (29.4% 1% 1 (1% p<0.0001. p00001 p p<0.0001 . 0 0001 (p<0.0001) CONCLUSION 20 366 36±6 68.6 (68.6% 66.6 (66.6% 55.8 5 (55.8% 50.9 (50.9% 39.3 (39.3% 29.4 2 (29.4 (1 p0000 p<0.000 000 (p<0.0001 36± 68. (68.6 66. (66.6 55. (55.8 50. (50.9 39. (39.3 29. (29. ( p000 p<0.00 00 (p<0.000 (68. (66. (55. (50. (39. (29 p00 p<0.0 (p<0.00 (68 (66 (55 (50 (39 (2 p0 p<0. (p<0.0 (6 (5 (3 p<0 (p<0. p< (p<0 (p< (p

Abstract In the pediatric population, complex regional pain syndrome (CRPS) is a challenging condition that leads to chronic psychosocial dysfunction. This case is of a 12-year-old male patient, 50 kg, who, after twisting his right ankle, started to present intense pain. Without adequate diagnosis and treatment, his family sought a pain specialist. During the evaluation, a change in sensitivity and temperature was observed, besides hyperalgesia, allodynia, redness, edema, and motor dysfunction, being diagnosed with CRPS. Ultrasound-guided sciatic blocks were performed on the affected limb, increasing the interval between crises, reducing pain intensity, and promoting a return to daily activities. population CRPS (CRPS dysfunction 12yearold yearold 12 year old patient 5 kg who ankle treatment specialist evaluation observed hyperalgesia allodynia redness edema Ultrasoundguided Ultrasound guided limb crises intensity activities 1

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é uma das causas mais prevalentes de incapacidade no mundo, e os efeitos adversos promovidos pelos analgésicos podem limitar o sucesso terapêutico. Nesse contexto, surge o laser como terapia complementar que pode potencializar a analgesia, sem aumentar incidência de eventos adversos indesejáveis. O objetivo deste estudo foi realizar uma revisão sistemática sobre a eficácia e a eficiência do laser de alta intensidade (LAI) no tratamento da dor. CONTEÚDO: Foi realizada uma busca sistemática nas plataformas Medline, LILACS, Pubmed e PEDro, de julho de 2020 a agosto de 2022. As palavras chaves dor, dor crônica, laser de alta intensidade e tratamento foram consideradas. A qualidade dos estudos clínicos selecionados foi avaliada utilizando a escala PEDro. As revisões sistemáticas incluídas foram avaliadas quanto à qualidade metodológica através da ferramenta AMSTAR. A principal medida estudada foi a intensidade de dor. Foram encontrados 227 estudos e com base nos critérios de inclusão e exclusão, 32 artigos foram lidos na íntegra, tendo sido excluído um por não avaliar a dor. As desordens musculoesqueléticas corresponderam a 70,96% das doenças avaliadas e a escala analógica visual (EAV) foi a única ferramenta de mensuração da dor utilizada em 100% dos estudos. Aproximadamente 57% dos estudos tinham alta qualidade metodológica (PEDro=7). Em 53,84% dos ensaios o LAI foi utilizado como intervenção única, e em 46,16% foi associado a exercícios. Em 96,15% dos ensaios clínicos e 100% das revisões sistemáticas, o LAI promoveu alívio da dor. CONCLUSÃO: O LAI é uma modalidade eficaz para analgesia ao promover significativo alívio da dor, rápida recuperação e melhora na qualidade de vida dos pacientes de forma segura. A diversidade nos parâmetros de irradiação (dose, duração, intervalo e número de sessões) empregados, indica a necessidade de mais estudos randomizados para estabelecer sua eficiência em longo prazo. OBJETIVOS mundo terapêutico contexto indesejáveis (LAI CONTEÚDO Medline LILACS PEDro 202 2022 crônica consideradas AMSTAR 22 exclusão 3 íntegra 7096 70 96 70,96 EAV (EAV 100 57 PEDro=7. PEDro7 PEDro=7 . 7 (PEDro=7) 5384 53 84 53,84 4616 46 16 46,16 exercícios 9615 15 96,15 CONCLUSÃO segura dose, dose (dose duração sessões empregados prazo 20 2 709 9 70,9 10 5 PEDro= (PEDro=7 538 8 53,8 461 4 1 46,1 961 96,1 70, (PEDro= 53, 46, 96, (PEDro

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the most prevalent causes of disability in the world, and the adverse effects promoted by analgesics can limit therapeutic success. In this context, laser appears as a complementary therapy that can enhance analgesia without increasing the incidence of undesirable adverse events. The aim of this study was to carry out a systematic review on the effectiveness and efficiency of high intensity laser (HIL) in the treatment of pain. CONTENTS: A systematic search was carried out in Medline, LILACS, Pubmed and PEDro, from July 2020 to August 2022. The keywords pain, chronic pain, high intensity laser and treatment were considered. The quality of selected studies was assessed using the PEDro scale. Included systematic reviews were assessed for methodological quality using the AMSTAR tool. The main measure studied was pain intensity. 227 studies were found and, based on the inclusion and exclusion criteria, 32 articles were read in full, whit one being excluded for not assessing pain. Musculoskeletal disorders corresponded to 70,96% of the assessed diseases and the visual analogue scale (VAS) was the only pain measurement tool used in 100% of the studies. Approximately 57% of the studies were of high methodological quality (PEDro=7). In 53,84% of the trials, HIL was used as a single intervention, and in 46,16% it was associated whit exercises. In 96.15% of clinical trials and 100% of systematic reviews there were positive effects of HIL on pain. CONCLUSION: HIL is an effective modality for analgesia by promoting significant pain relief, rapid recovery and improvement in patient’s quality of life, in a safe way. The diversity in irradiation parameters (dose, duration, interval and number of sessions) used, indicates the need for further randomized studies to establish its long-term efficiency. OBJECTIVES world success context events (HIL CONTENTS Medline LILACS 202 2022 considered 22 criteria 3 full 7096 70 96 70,96 VAS (VAS 100 57 PEDro=7. PEDro7 PEDro=7 . 7 (PEDro=7) 5384 53 84 53,84 intervention 4616 46 16 46,16 exercises 9615 15 96.15 CONCLUSION relief patients patient s life way dose, dose (dose duration sessions longterm long term 20 2 709 9 70,9 10 5 PEDro= (PEDro=7 538 8 53,8 461 4 1 46,1 961 96.1 70, (PEDro= 53, 46, 96. (PEDro

SUMMARY OBJECTIVE: This study aimed to evaluate postoperative pain and quality of life in patients undergoing median sternotomy. METHODS: A cohort study was carried out on a sample of 30 patients who underwent elective cardiac surgery by longitudinal median sternotomy. Patients were interviewed at Intensive Care Unit discharge and hospital discharge, when the Visual Numeric Scale and the Brief Pain Inventory were applied, and 2 weeks after hospital discharge, when the World Health Organization Quality of Life-Bref questionnaire was administered. The normality of the results was analyzed by the Shapiro-Wilk test, and Wilcoxon Rank Sum and McNemar tests were utilized for the analysis of numerical and categorical variables. For correlation between numerical variables, Spearman's linear correlation test was applied. To compare numerical variables, Mann-Whitney U and Kruskal-Wallis tests were applied. Differences between groups were considered significant when the p-value was <0.05. RESULTS: Between Intensive Care Unit and hospital discharge, there was a reduction in median pain intensity assessed by the Visual Numeric Scale from 5.0 to 2.0 (p<0.001), as well as in eight Brief Pain Inventory parameters: worst pain intensity in the last 24 h (p=0.001), analgesic relief (p=0.035), and pain felt right now (p=0.009); and in interference in daily activities (p<0.001), mood (p=0.017), ability to walk (p<0.001), relationship with other people (p=0.005), and sleep (p=0.006). Higher pain intensity at Intensive Care Unit discharge was associated with worse performance in the psychological domain of quality of life at out-of-hospital follow-up. CONCLUSION: Proper management of post-sternotomy pain in the Intensive Care Unit may imply better quality of life at out-of-hospital follow-up. OBJECTIVE sternotomy METHODS 3 applied LifeBref Life Bref administered ShapiroWilk Shapiro Wilk variables Spearmans Spearman s MannWhitney Mann Whitney KruskalWallis Kruskal Wallis pvalue p value 005 0 05 <0.05 RESULTS 50 5 5. 20 2. p<0.001, p0001 p<0.001 , 001 (p<0.001) parameters p=0.001, p=0.001 (p=0.001) p=0.035, p0035 p=0.035 035 (p=0.035) p=0.009 p0009 009 (p=0.009) p=0.017, p0017 p=0.017 017 (p=0.017) p=0.005, p0005 p=0.005 (p=0.005) p=0.006. p0006 p=0.006 . 006 (p=0.006) outofhospital followup. followup follow up. up follow-up CONCLUSION poststernotomy post 00 <0.0 p000 p<0.00 (p<0.001 p=0.00 (p=0.001 p003 p=0.03 03 (p=0.035 (p=0.009 p001 p=0.01 01 (p=0.017 (p=0.005 (p=0.006 <0. p00 p<0.0 (p<0.00 p=0.0 (p=0.00 (p=0.03 (p=0.01 <0 p0 p<0. (p<0.0 p=0. (p=0.0 < p<0 (p<0. p=0 (p=0. p< (p<0 p= (p=0 (p< (p= (p

SUMMARY OBJECTIVE: This study aimed to comparatively analyze sociodemographic data and postoperative parameters of patients undergoing bypass and sleeve surgeries in a private hospital in São Luís, MA. METHODS: The study was descriptive, prospective, observational, and comparative, with a quantitative approach between August 2020 and July 2021. We analyzed 74 participants of both genders, aged between 18 and 70 years, with 31 undergoing Roux-en-Y gastric bypass surgery and 43 undergoing sleeve gastrectomy surgery. In the postoperative period, sociodemographic characteristics, surgery and anesthesia duration, pain levels, adverse effects, weight loss, and complications from the surgical procedure were analyzed. RESULTS: Males predominated in Roux-en-Y gastric bypass and females in sleeve gastrectomy surgery. Clinical characteristics regarding self-declared ethnicity, age and place of birth, education, and marital status were similar between the studied groups. Roux-en-Y gastric bypass had an average surgery time of 112.14±10.06 min and sleeve gastrectomy 91.11±23.69 min, with a significant difference (p<0.001). Regarding anesthesia time, gastric bypass averaged 160.36±13.99 min and sleeve gastrectomy 154.88±29.10 min, with no statistical difference between groups (p=0.335). Nausea, vomiting, and drowsiness were more common in Sleeve gastrectomy, with no significant difference (p=0.562). Roux-en-Y gastric bypass showed a higher rate of weight loss from 1 month after surgery (14.2±4.15) and more variation in body mass index within 3 months after surgery (32.17±4.76). Complications occurred in a small number of patients. CONCLUSION: The two surgical techniques proved effective in delivering the best results for patients, with the group undergoing bypass showing statistically significant weight loss from 1 month after the surgical procedure. OBJECTIVE Luís MA METHODS descriptive prospective observational comparative 202 2021 7 genders years RouxenY Roux en Y 4 period duration levels effects RESULTS selfdeclared self declared ethnicity birth education 112141006 112 14 10 06 112.14±10.0 91112369 91 11 23 69 91.11±23.6 p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) 160361399 160 36 13 99 160.36±13.9 154882910 154 88 29 154.88±29.1 p=0.335. p0335 p=0.335 335 (p=0.335) Nausea vomiting p=0.562. p0562 p=0.562 562 (p=0.562) 14.2±4.15 142415 2 15 (14.2±4.15 32.17±4.76. 3217476 32.17±4.76 32 17 76 (32.17±4.76) CONCLUSION 20 11214100 112.14±10. 9111236 9 6 91.11±23. p000 p<0.00 00 (p<0.001 16036139 16 160.36±13. 15488291 8 154.88±29. p033 p=0.33 33 (p=0.335 p056 p=0.56 56 (p=0.562 14.2±4.1 14241 (14.2±4.1 321747 32.17±4.7 (32.17±4.76 1121410 112.14±10 911123 91.11±23 p00 p<0.0 (p<0.00 1603613 160.36±13 1548829 154.88±29 p03 p=0.3 (p=0.33 p05 p=0.5 5 (p=0.56 14.2±4. 1424 (14.2±4. 32174 32.17±4. (32.17±4.7 112141 112.14±1 91112 91.11±2 p0 p<0. (p<0.0 160361 160.36±1 154882 154.88±2 p=0. (p=0.3 (p=0.5 14.2±4 142 (14.2±4 3217 32.17±4 (32.17±4. 11214 112.14± 9111 91.11± p<0 (p<0. 16036 160.36± 15488 154.88± p=0 (p=0. 14.2± (14.2± 321 32.17± (32.17±4 1121 112.14 911 91.11 p< (p<0 1603 160.36 1548 154.88 p= (p=0 14.2 (14.2 32.17 (32.17± 112.1 91.1 (p< 160.3 154.8 (p= 14. (14. 32.1 (32.17 112. 91. (p 160. 154. (14 32. (32.1 (1 (32. ( (32 (3

SUMMARY OBJECTIVE: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment. METHODS: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients’ quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used. RESULTS: There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001). CONCLUSION: Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire. OBJECTIVE METHODS observational longitudinal 10 30item item 30 EHP30 EHP (EHP-30 170 17 0 17.0 used RESULTS EHP-3 PART 1 A B C E p<0.0001. p00001 p p<0.0001 . 0001 (p<0.0001) D CONCLUSION EHP3 (EHP-3 17. EHP- p0000 p<0.000 000 (p<0.0001 (EHP- p000 p<0.00 00 (p<0.000 (EHP p00 p<0.0 (p<0.00 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

ABSTRACT Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters. Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before and after endometriosis resection surgery. Clinical history, image exams, the Female Lower Urinary Tract Symptoms questionnaire, urodynamic examination, cystometry, and voiding study were evaluated. Results: Patients aged 30–39 years old, operative duration of 132.5 minutes, and 2.7 days of hospital stay. Uroflowmetry and cystometry showed tendency for an increase after the surgery in the flow duration, time to maximum flow, and first voiding desire and decreased residual volume and maximum cystometric capacity. Opening, maximum urinary flow, and maximum flow pressure decreased at T1, and the closing parameters increased, although statistically non significant. The variables decreased at T1 in the urodynamic, except for detrusor overactivity. Although we observed a reasonable number of low bladder compliance and abnormal bladder sensation, the results were maintained at T1. General scores for filling and incontinence showed a significant decrease after surgery. Conclusions: A significant response in the patient’s perception of urinary function was demonstrated after surgery. It is observed that the surgical procedure did not affect the uroflowmetric and cystometric characteristics of the evaluated patients. Purpose Methods history exams questionnaire examination Results 3039 30 39 30–3 old 1325 132 5 132. minutes 27 2 7 2. stay capacity Opening T increased overactivity sensation Conclusions patient s 303 3 30– 13 1

ABSTRACT Purpose: To demonstrate through a controlled study whether the use of tranexamic acid in bariatric surgeries is effective for bleeding control. Methods: Prospective, comparative, and double-blind study performed with patients from 18 to 65 years old submitted to bariatric surgery. The selected patients received venous tranexamic acid (TXA) during the induction of anesthesia or not (CG). The anesthesia and thromboprophylaxis protocols were similar among the groups. For statistical analysis, the χ2 and analysis of variance tests were performed at a significance level of p < 0.05, using the statistical program SPSS 21.0®. Results: Sixty-one patients were included in the study, 31 in the control group and 30 in the TXA group (GTXA). In the intraoperative period, the bleeding volume was greater in the CG than in the GTXA. In the postoperative period, the tranexamic acid group had a higher value hematocrit, absence of surgical reoperations due to bleeding complications, and shorter hospitalization time than the control group. Conclusions: The use of tranexamic acid was effective in reducing bleeding rates and of hospital stay length, in addition to demonstrating the clinical safety of its use, for not having been associated with any thromboembolic events.