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Summary Reasons for performing study: Bradycardia may be implicated as a cause of cardiovascular instability during anaesthesia. Hypothesis: Hyoscine would induce positive chronotropism of shorter duration than atropine, without adversely impairing intestinal motility in detomidine sedated horses. Methods: Ten minutes after detomidine (0.02 mg/kg bwt, i.v.), physiological saline (control), atropine (0.02 mg/kg bwt) or hyoscine (0.2 mg/kg bwt) were randomly administered i.v. to 6 horses, allowing one week intervals between treatments. Investigators blinded to the treatments monitored cardiopulmonary data and intestinal auscultation for 90 min and 24 h after detomidine, respectively. Gastrointestinal transit was assessed for 96 h via chromium detection in dry faeces. Results: Detomidine significantly decreased heart rate (HR) and cardiac index (CI) from baseline for 30 and 60 min, respectively (control). Mean ± s.d. HR increased significantly 5 min after atropine (79 ± 5 beats/min) and hyoscine (75 ± 8 beats/min). After this time, HR was significantly higher after atropine in comparison to other treatments, while hyoscine resulted in intermediate values (lower than atropine but higher than controls). Hyoscine and atropine resulted in significantly higher CI than controls for 5 and 20 min, respectively; but this effect coincided with significant hypertension (mean arterial pressures >180 mmHg). Auscultation scores decreased from baseline in all treatments. Time to return to auscultation scores ≥12 (medians) did not differ between hyoscine (4 h) and controls (4 h) but atropine resulted in significantly longer time (10 h). Atropine induced colic in one horse. Gastrointestinal transit times did not differ between treatments. Conclusion: Hyoscine is a shorter acting positive chronotropic agent than atropine, but does not potentiate the impairment in intestinal motility induced by detomidine. Because of severe hypertension, routine use of anticholinergics combined with detomidine is not recommended. Potencial relevance: Hyoscine may represent an alternative to atropine for treating bradycardia.

Made available in DSpace on 2018-12-11T17:00:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01 In 2006, a previous study at our institution reported high perioperative and anesthesia-related mortality rates of 21.97 and 1.12 per 10,000 anesthetics, respectively. Since then, changes in surgical practices may have decreased these rates. However, the actual perioperative and anesthesia-related mortality rates in Brazil remains unknown. The study aimed to reexamine perioperative and anesthesia-related mortality rates in one Brazilian tertiary teaching hospital. In this observational study, deaths occurring in the operation room and postanesthesia care unit between April 2005 and December 2012 were identified from an anesthesia database. The data included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA) physical status, and medical specialty teams, as well as the types of surgery and anesthesia. All deaths were reviewed and grouped by into 1 of 4 triggering factors groups: totally anesthesia-related, partially anesthesia-related, surgery-related, or disease/conditionrelated. The mortality rates are expressed per 10,000 anesthetics with 95% confidence intervals (CIs). A total of 55,002 anesthetics and 88 deaths were reviewed, representing an overall mortality rate of 16.0 per 10,000 anesthetics (95% CI: 13.0-19.7). There were no anesthesia-related deaths. The major causes of mortality were patient disease/condition-related (13.8, 95% CI: 10.7-16.9) followed by surgery-related (2.2, 95% CI: 1.0-3.4). The major risks of perioperative mortality were children younger than 1-year-old, older patients, patients with poor ASA physical status (III-V), emergency, cardiac or vascular surgeries, and multiple surgeries performed under the same anesthetic technique (P < 0.0001). There were no anesthesia-related deaths. However, the high mortality rate caused by the poor physical conditions of some patients suggests that primary prevention might be the key to reducing perioperative mortality. These findings demonstrate the need to improve medical perioperative practices for high-risk patients in under-resourced settings. Anesthesia Cardiac Arrest and Mortality Study Commission Department of Anesthesiology Botucatu Medical School UNESP University Estadual Paulista Department of Biostatistics Institute of Biosciences UNESP University Estadual Paulista Anesthesia Cardiac Arrest and Mortality Study Commission Department of Anesthesiology Botucatu Medical School UNESP University Estadual Paulista Department of Biostatistics Institute of Biosciences UNESP University Estadual Paulista

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:44:06Z No. of bitstreams: 1 S1807-59322012000400012.pdf: 100696 bytes, checksum: 4e7ee5010b3dd13a913f9a2bf6d9d5df (MD5) Made available in DSpace on 2013-08-22T18:44:06Z (GMT). No. of bitstreams: 1 S1807-59322012000400012.pdf: 100696 bytes, checksum: 4e7ee5010b3dd13a913f9a2bf6d9d5df (MD5) Previous issue date: 2012-01-01 Made available in DSpace on 2013-09-30T18:15:58Z (GMT). No. of bitstreams: 2 S1807-59322012000400012.pdf: 100696 bytes, checksum: 4e7ee5010b3dd13a913f9a2bf6d9d5df (MD5) S1807-59322012000400012.pdf.txt: 38341 bytes, checksum: e6a7fe778b83ae9cb79acb86dd480d07 (MD5) Previous issue date: 2012-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:32:16Z No. of bitstreams: 2 S1807-59322012000400012.pdf: 100696 bytes, checksum: 4e7ee5010b3dd13a913f9a2bf6d9d5df (MD5) S1807-59322012000400012.pdf.txt: 38341 bytes, checksum: e6a7fe778b83ae9cb79acb86dd480d07 (MD5) Made available in DSpace on 2014-05-20T13:32:16Z (GMT). No. of bitstreams: 2 S1807-59322012000400012.pdf: 100696 bytes, checksum: 4e7ee5010b3dd13a913f9a2bf6d9d5df (MD5) S1807-59322012000400012.pdf.txt: 38341 bytes, checksum: e6a7fe778b83ae9cb79acb86dd480d07 (MD5) Previous issue date: 2012-01-01 This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (