RESUMO Objetivo: estimar o excesso de óbitos durante a pandemia de covid-19 em Santa Catarina e suas macrorregiões, Brasil, 2020-2021. Métodos: estudo ecológico, com dados do Sistema de Informações sobre Mortalidade; o excesso de óbitos em adultos foi calculado pela diferença entre óbitos observados e óbitos esperados, considerando-se a média das mortes ocorridas entre 2015 e 2019; foram analisadas as variáveis “macrorregião de residência”, “trimestre”, “mês”, “sexo” e “faixa etária”; os dados foram analisados descritivamente. Resultados: excesso de 6.315 óbitos em 2020 e de 17.391 em 2021, majoritariamente no sexo masculino (57,4%) e nas idades acima de 60 anos (74,0%); as macrorregiões e períodos com maior excedente foram aqueles com mais mortes por covid-19; o maior excesso ocorreu em março de 2021 (n = 4.207), com queda progressiva até o final do ano. Conclusão:houve excesso de óbitos em Santa Catarina e todas as suas macrorregiões durante a pandemia de covid-19.

RESUMEN Objetivo: estimar el exceso de muertes en Santa Catarina y macrorregiones durante la pandemia de COVID-19, en los años 2020 y 2021. Métodos: estudio ecológico utilizando Sistema de Información de Mortalidad. El exceso de defunciones en adultos se calculó por la diferencia entre defunciones observadas y esperadas, considerando el promedio de defunciones entre 2015 y 2019. Las variables analizadas fueron: macrorregión de residencia, trimestre, mes, sexo y grupo de edad. Los datos se analizaron descriptivamente. Resultados: el exceso fue de 6.315 defunciones en 2020 y 17.391 en 2021, mayor en varones (57,4%) y mayores de 60 años (74,0%). Las macrorregiones y periodos con mayor superávit fueron los que registraron más muertes por COVID-19. El mayor exceso de muertes ocurrió en marzo de 2021 (n=4.207), con una disminución progresiva hasta el final del año. Conclusión: hubo exceso de muertes en Santa Catarina y en todas macrorregiones durante la pandemia de COVID-19.

ABSTRACT Objective: to estimate excess deaths during the COVID-19 pandemic in the state of Santa Catarina and its macro-regions, Brazil, 2020-2021. Methods: this was an ecological study, using data from the Mortality Information System; excess deaths in adults were calculated by the difference between the observed number of deaths and expected number of deaths, taking into account the average of deaths that occurred between 2015 and 2019; the variables “macro-region of residence”, “quarter”, “month”, “sex” and “age group” were analyzed; data were analyzed in a descriptive manner. Results: a total of 6,315 excess deaths in 2020 and 17,391 in 2021, mostly in males (57.4%) and those aged 60 years and older (74.0%); macro-regions and periods with the greatest excess deaths were those in which there were most deaths due to COVID-19; the greatest excess deaths occurred in March 2021 (n = 4,207), with a progressive decrease until the end of the year. Conclusion: there were excess deaths in the state of Santa Catarina and in all its macro-regions during the COVID-19 pandemic.

ABSTRACT Objective: to estimate excess deaths during the COVID-19 pandemic in the state of Santa Catarina and its macro-regions, Brazil, 2020-2021. Methods: this was an ecological study, using data from the Mortality Information System; excess deaths in adults were calculated by the difference between the observed number of deaths and expected number of deaths, taking into account the average of deaths that occurred between 2015 and 2019; the variables “macro-region of residence”, “quarter”, “month”, “sex” and “age group” were analyzed; data were analyzed in a descriptive manner. Results: a total of 6,315 excess deaths in 2020 and 17,391 in 2021, mostly in males (57.4%) and those aged 60 years and older (74.0%); macro-regions and periods with the greatest excess deaths were those in which there were most deaths due to COVID-19; the greatest excess deaths occurred in March 2021 (n = 4,207), with a progressive decrease until the end of the year. Conclusion: there were excess deaths in the state of Santa Catarina and in all its macro-regions during the COVID-19 pandemic.

RESUMEN Objetivo: estimar el exceso de muertes en Santa Catarina y macrorregiones durante la pandemia de COVID-19, en los años 2020 y 2021. Métodos: estudio ecológico utilizando Sistema de Información de Mortalidad. El exceso de defunciones en adultos se calculó por la diferencia entre defunciones observadas y esperadas, considerando el promedio de defunciones entre 2015 y 2019. Las variables analizadas fueron: macrorregión de residencia, trimestre, mes, sexo y grupo de edad. Los datos se analizaron descriptivamente. Resultados: el exceso fue de 6.315 defunciones en 2020 y 17.391 en 2021, mayor en varones (57,4%) y mayores de 60 años (74,0%). Las macrorregiones y periodos con mayor superávit fueron los que registraron más muertes por COVID-19. El mayor exceso de muertes ocurrió en marzo de 2021 (n=4.207), con una disminución progresiva hasta el final del año. Conclusión: hubo exceso de muertes en Santa Catarina y en todas macrorregiones durante la pandemia de COVID-19.

RESUMO Objetivo: estimar o excesso de óbitos durante a pandemia de covid-19 em Santa Catarina e suas macrorregiões, Brasil, 2020-2021. Métodos: estudo ecológico, com dados do Sistema de Informações sobre Mortalidade; o excesso de óbitos em adultos foi calculado pela diferença entre óbitos observados e óbitos esperados, considerando-se a média das mortes ocorridas entre 2015 e 2019; foram analisadas as variáveis “macrorregião de residência”, “trimestre”, “mês”, “sexo” e “faixa etária”; os dados foram analisados descritivamente. Resultados: excesso de 6.315 óbitos em 2020 e de 17.391 em 2021, majoritariamente no sexo masculino (57,4%) e nas idades acima de 60 anos (74,0%); as macrorregiões e períodos com maior excedente foram aqueles com mais mortes por covid-19; o maior excesso ocorreu em março de 2021 (n = 4.207), com queda progressiva até o final do ano. Conclusão:houve excesso de óbitos em Santa Catarina e todas as suas macrorregiões durante a pandemia de covid-19.

Abstract Background Up to 60% of pediatric surgical patients develop high levels of preoperative anxiety. This study compared the effects of oral combinations of midazolam and ketamine with oral midazolam alone for pediatric preanesthetic medication. Methods The study protocol was registered in PROSPERO as CRD42020172920. A systematic literature search was conducted using Medline, Cochrane, EMBASE, CENTRAL, and Web of Science for randomized controlled trials comparing oral combinations of midazolam and ketamine with midazolam alone as preanesthetic medication in elective surgical pediatric patients. Meta-analyses included the following outcomes: anxiety and sedation levels, child’s behavior during separation from parents, face mask acceptance, and venipuncture. The quality of evidence was assessed using GRADE criteria. Results Twenty studies were included. The following effects (RR (95% CI)) were observed for combinations of ketamine and midazolam relative midazolam alone: anxiolysis (1.2 (0.94-1.52); p= 0.15; I2 = 80%; GRADE = very low); satisfactory sedation (1.2 ( 1.10-1.31); p< 0.001; I2 = 71%; GRADE = very low); behavior during parental separation (1.2 (1.06-1.36); p= 0.003; I2 = 88%; GRADE = very low); facial mask acceptance (1.13 (1.04-1.24); p= 0.007; I2 = 49%; GRADE = very low); behavior during venipuncture (1.32 (1.11-1.57); p= 0.002; I2 = 66%; GRADE = very low). Conclusions While similar probabilities of obtaining anxiolysis were found, adequate sedation, calm behavior during child’s separation from parents, low levels of fear during face mask adaptation, and cooperative behavior during peripheral venous cannulation were more likely with midazolam-ketamine combinations.