ANGELA MARIA SOUSA

(Fonte: Lattes)
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 29
  • article 6 Citação(ões) na Scopus
    Tramadol wound infiltration is not different from intravenous tramadol in children: a randomized controlled trial
    (2016) GIRALDES, Ana Laura Albertoni; SOUSA, Angela Maria; SLULLITEL, Alexandre; GUIMARAES, Gabriel Magalhaes Nunes; SANTOS, Melina Genevieve Mary Egan; PINTO, Renata Evangelista; ASHMAWI, Hazem Adel; SAKATA, Rioko Kimiko
    Study Objective: The purpose of this trial was to assess if tramadol wound infiltration is superior to intravenous (IV) tramadol after minor surgical procedures in children because tramadol seems to have local anesthetic like effect. Design: Randomized double-blind controlled trial. Setting: Postanesthesia care unit. Patients: Forty children, American Society of Anesthesiologists physical status I or II, scheduled to elective inguinal hernia repair. Interventions: Children were randomly distributed in 1 of 2 groups: IV tramadol (group 1) or subcutaneous infiltration with tramadol (group 2). At the end of the surgery, group 1 received 2 mg/kg tramadol (3 mL) by IV route and 3-mL saline into the surgical wound; group 2 received 2 mg/kg tramadol (3 mL) into the surgical wound and 3-mL saline by IV route. Measurements: In the postanesthesia care unit, patients were evaluated for pain intensity, nausea and vomiting, time to first rescue medication, and total rescue morphine and dipyrone consumption. Main Results: Pain scores measured during the postanesthesia recovery time were similar between groups. Time to first rescue medication was shorter, but not statistically significant in the IV group. The total dose of rescue morphine and dipyrone was also similar between groups. Conclusions: We concluded that tramadol was effective in reducing postoperative pain in children, and there was no difference in pain intensity, nausea and vomiting, or somnolence regarding IV route or wound infiltration.
  • article 20 Citação(ões) na Scopus
    Safety profile of intravenous patient-controlled analgesia for breakthrough pain in cancer patients: a case series study
    (2014) SOUSA, Angela Maria; SANTANA NETO, Jose de; GUIMARAES, Gabriel M. N.; CASCUDO, Giovana M.; NETO, Jose Osvaldo B.; ASHMAWI, Hazem A.
    The WHO analgesic ladder supports medication choice according to pain intensity. The use of the analgesic ladder in an inverse way, has the advantage of using the same principles of the original ladder to treat crisis of pain in cancer patients. The purpose of this study is to describe the use of intravenous patient-controlled analgesia (IV-PCA) technique in patients admitted to an oncological Hospital. This is a case series study. Patients assigned to receive IV-PCA between March 2011 and May 2012 were selected for the study. Medical records were reviewed, patients stratified according to the Karnofsky Performance Score (KPS). The primary outcome was to verify if different IV-PCA opioid solutions could be equally effective providing pain relief. Secondary outcomes were the incidence of clinical side effects that can be associated to IV-PCA infusions. A total of 95 medical records were reviewed. Most patients used IV-PCA with morphine (42.1 %), fentanyl (42.1 %) or methadone (15.7 %) to treat exacerbation periods of cancer pain. IV-PCA used as supplementary therapy successfully improved pain control in 78.9 % of the patients, without any difference related to opioid solution. KPS < 40 was related to higher rate of pain relief, without any difference in side effects in this group of patients. The most common side effects were sedation (10.5 %) followed by constipation (9.4 %) and nausea (4.2 %). Morphine presented a higher risk than fentanyl for sedation. Analgesia-related delirium or respiratory depression were not reported in this case series study. IV-PCA provided timely, safe and useful analgesia for patients with severe breakthrough pain and may be useful to help titration of opioids, weaning to oral analgesia and to decide for interventional procedures.
  • article 20 Citação(ões) na Scopus
    Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models
    (2012) SOUSA, A. M.; ASHMAWI, H. A.; COSTA, L. S.; POSSO, I. P.; SLULLITEL, A.
    Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 +/- 1.1, 12.7 +/- 1.8, 8.4 +/- 0.8, and 11.1 +/- 3.3 s) and mechanical threshold in response to von Frey filaments (459 +/- 82.8, 447.5 +/- 91.7, 320.1 +/- 120, 126.43 +/- 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.
  • article
    Bloqueio do sistema nervoso simpático para tratamento de dor do membro fantasma: relato de caso
    (2013) MORAES, Marcos Fernando Breda de; BARBOSA NETO, José Osvaldo; VANETTI, Thaís Khouri; MORAIS, Luciana Chaves de; SOUSA, Ângela Maria; ASHMAWI, Hazem Adel
    BACKGROUND AND OBJECTIVES: Phantom limb sensation is a phenomenon affecting patients submitted to amputation of any limb and this sensation may or may not be followed by pain. This report aimed at presenting a case where sympathetic nervous system block was used as adjuvant to control phantom limb pain. CASE REPORT: Patient with wrist epidermoid carcinoma, who evolved with phantom limb pain after left forearm amputation. Patient was submitted to conservative treatment and physical rehabilitation, however drug therapy analgesia was insufficient and patient evolved with pain in the amputation stump and sympathetic nervous system-mediated pain. Ultimately, patient was submitted to sympathetic venous block followed by diagnostic chest sympathetic chain block with significant pain decrease. CONCLUSION: Sympathetic nervous system block in this case was induced with venous lidocaine infusion, followed by chest sympathetic chain block as therapeutic option for phantom limb pain. This sequence has provided pain relief without adverse effects.
  • bookPart
    Agonistas e antagonista opioides
    (2017) SOUSA, Angela Maria; SLULLITEL, Alexandre; ASHMAWI, Hazem Adel; TAHAMTANI, Sílvia Maria Machado; VANETTI, Thais Khouri
  • bookPart
    Cuidados e intervenções em pacientes com metástase óssea
    (2014) SILVA, Adriana Marques da; SOUSA, Angela Maria; VASCONCELOS, Karina Gondim Moutinho da Conceição; ALMEIDA, Luciana Alexandra Antônia de; CORREIA, Luiz Filipe Marques; ANDRADE, Lydia Caldeira Tavares de Oliveira; DIZ, Maria Del Pilar Estevez; SOARES, Melissa Wilhelm; CECATTO, Rebeca Boltes; ANDRADE, Rodrigo Guimarãesde; TEIXEIRA, William Gemio Jacobsen
  • article 0 Citação(ões) na Scopus
  • article 3 Citação(ões) na Scopus
    Olanzapine as an add-on, pre-operative anti-emetic drug for postoperative nausea or vomiting: a randomised controlled trial
    (2023) GRIGIO, T. R.; TIMMERMAN, H.; MARTINS, J. V. B.; SLULLITEL, A.; WOLFF, A. P.; SOUSA, A. M.
    Postoperative nausea or vomiting occurs in up to 40% in patients with multiple risk factors, despite prophylaxis. Olanzapine is an antipsychotic drug that is used to prevent nausea and vomiting in palliative care and to treat chemotherapy-induced nausea and vomiting. This study aimed to examine whether pre-operative olanzapine, as a prophylactic anti-emetic added to intra-operative dexamethasone, ondansetron and total intravenous anaesthesia, reduced the incidence of postoperative nausea or vomiting. We performed a multiply-blinded randomised controlled trial in patients aged 18-60 years with cancer at high risk of postoperative nausea or vomiting (three or four risk factors according to the Apfel criteria) plus a previous history of chemotherapy-induced nausea and vomiting. Patients were allocated at random to receive 10 mg olanzapine or placebo orally 1 h before surgery in addition to a two-drug regimen (dexamethasone and ondansetron) and propofol anaesthesia to prevent postoperative nausea or vomiting. The primary outcome was the incidence of postoperative nausea or vomiting in the first 24 h after surgery. In total, 100 patients were enrolled; 47 in the olanzapine group and 49 in the control group completed the study. The baseline characteristics of the groups were similar. The incidence of postoperative nausea or vomiting in the first 24 h after surgery was lower in the olanzapine group (12/47, 26%) than in the control group (31/49, 63%) (p = 0.008, RR 0.40 (95%CI 0.21-0.79)). Adding pre-operative oral olanzapine to intra-operative dexamethasone and ondansetron was highly effective in reducing the risk of postoperative nausea or vomiting in the first 24 hours after surgery in patients with a previous history of chemotherapy-induced nausea and vomiting and at least three Apfel risk factors for postoperative nausea or vomiting.
  • article
    Bloqueio neurolítico subaracnoideo em paciente com dor oncológica refratária: relato de caso
    (2013) BARBOSA NETO, José Osvaldo; SOUSA, Ângela Maria; TAHANTAMI, Silvia Maria Machado; ASHMAWI, Hazem Adel
    BACKGROUND AND OBJECTIVES: The use of subarachnoid neurolytic blockade to control pain has decreased in recent years due to the introduction of new techniques, but it is still important to control refractory cancer pain. This study aimed at presenting a case of cancer pain where this technique was used to control pain. CASE REPORT: Male patient, 45 years old, with locally advanced anal canal scamous cell carcinoma and ulcerated lesion in perineal region with enterovesical fistula and local infection. Patient had severe pain with numerical verbal scale (NVS) = 10 and was being pharmacologically treated with high opioid doses and adjuvants without good response. Subarachnoid neurolytic blockade was induced with 5% phenol with significant pain relief; 20 minutes after the procedure patient has referred 80% relief. Improvement has remained for 21 days when patient died due to infectious complications. CONCLUSION: This case has illustrated the use of subarachnoid blockade with 5% phenol to control cancer pain. The conclusion is that for selected cases, where life expectation is limited, this technique may be successfully used.
  • conferenceObject
    Evaluation of predictive factors for postoperative nausea and vomiting in hepatobiliary cancer patients
    (2022) PEREIRA, Juliana Fernanda Holanda Bezerra; PEREIRA, Luciano Beltrao; MILAN, Zoka; SOUSA, Angela; SIMOES, Claudia Marquez