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Abstract Allopurinol is a potent inhibitor of the enzyme xanthine oxidase used in the treatment of hyperuricemia and gout. The aim of this pilot study was to investigate the effects of allopurinol on pain and anxiety in women displaying fibromyalgia refractory to conventional therapy. This prospective case series enrolled 12 women with previous diagnosis of fibromyalgia refractory to conventional therapy. Patients received an add-on therapy with oral allopurinol 300 mg twice daily for 30 days. Patients were submitted to evaluation for pain and anxiety scores before treatment, 15 and 30 days thereafter. This pilot study has demonstrated that oral administration of allopurinol 300 mg twice daily caused a significant reduction on pain scores up to 30 days of treatment in women with fibromyalgia. No effect was observed regarding anxiety scores. Randomized clinical trials are warranted and should further investigate allopurinol and more selective purine derivatives in the management of acute or chronic pain conditions.

https://doi.org/10.1016/j.bjane.2020.12.016

Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study
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Bevilacqua Filho, Clovis T.

; Schmidt, André P.

; Felix, Elaine A.

; Bianchi, Fabiana

; Guerra, Fernanda M.

; Andrade, Cristiano F.

Brazilian Journal of Anesthesiology

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Ago 2021, Volume 71 Nº 4 Páginas 333 - 338

Resumo: En | Texto: En | PDF: En

Abstract Background Postoperative pulmonary complications are the main cause of morbidity and mortality after pulmonary resection. This study was undertaken to determine the risk factors associated with postoperative pulmonary complications (PPCs) and length of hospital stay (LOS) in pulmonary resection patients in a tertiary teaching hospital in Brazil. Methods A retrospective data gathering from 196 patients who underwent pulmonary resection between 2012 and 2016 was conducted. Demographic and hospital admission data were collected from patients with complete medical records. Univariate analysis was performed, followed by Poisson's regression for predicting the prevalence of postoperative pulmonary complications and length of hospital stay. Results Thirty-nine patients (20%) displayed pulmonary complications in the postoperative period. The risk factors associated with an increased prevalence of postoperative pulmonary complications in a multivariate analysis were: American Society of Anesthesiologists physical status (ASA) ≥ 3 (PR 4.77, p = 0.03, 95% CI: 1.17 to 19.46), predicted diffusion capacity of the lungs for carbon monoxide- corrected single breath (PR 0.98, p < 0.001, 95% CI: 0.96 to 0.99) and age of the patient (PR 1.04; p = 0.01; 95% CI: 1.01 to 1.06). Those associated with an increased prevalence of prolonged hospital stay were: duration of surgical procedure longer than five hours (PR 6.94, p = 0.01, 95% CI: 1.66 to 12.23), male sex (PR 5.72, p < 0.001, 95% CI: 1.87 to 9.58), and presence of postoperative pulmonary complications (PR 11.92, p < 0.001, 95% CI: 7.42 to 16.42). Conclusions The rate of postoperative pulmonary complications in the study population is in line with the world average. Recognizing risk factors for the development of PPCs may help optimize allocation resources and preventive efforts.

https://doi.org/10.1016/j.bjane.2021.02.003 1062 downloads

10.

Epidural analgesia in the obese obstetric patient
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Caetano, Ana Maria M.

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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Jun 2021, Volume 71 Nº 3 Páginas 207 - 207

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.04.026

11.

Challenges in obstetric anesthesia
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Caetano, Ana Maria M.

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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Jun 2021, Volume 71 Nº 3 Páginas 205 - 206

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.04.025 48 downloads

12.

Epidural analgesia in the obese obstetric patient
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Caetano, Ana Maria M.

; Schmidt, André P.

Brazilian Journal of Anesthesiology

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2021, Nº ahead

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjane.2021.04.026 292 downloads

13.

Serum biomarkers of brain injury: S100B protein, cognitive dysfunction, and major non-cardiac surgery
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Schmidt, André P.

; Carmona, Maria José C.

Revista Brasileira de Anestesiologia

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Dez 2020, Volume 70 Nº 6 Páginas 570 - 572

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1016/j.bjane.2020.10.006 240 downloads

14.

Prevention of postoperative nausea and vomiting: new insights for patient care
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Schmidt, André P.

Revista Brasileira de Anestesiologia

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Out 2020, Volume 70 Nº 5 Páginas 452 - 454

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1016/j.bjane.2020.09.004 373 downloads

15.

Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study
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Auler Junior, José Otavio Costa

; Torres, Marcelo L.A.

; Cardoso, Mônica M.

; Tebaldi, Thais C

; Schmidt, André P.

; Kondo, Mario M.

; Zugaib, Marcelo

Clinics

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Jun 2010, Volume 65 Nº 8 Páginas 793 - 798

Resumo: En | Texto: En | PDF: En

BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

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