PEDRO HILTON DE ANDRADE FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Analgesic efficacy of erector spinae plane block versus paravertebral block in lung surgeries-A non-inferiority randomised controlled trial(2024) ANDRADE FILHO, Pedro Hilton de; PEREIRA, Victor Egypto; SOUSA, Daniel da Escossia Melo; COSTA, Ladyer da Gama; NUNES, Yuri Pinto; TAGLIALEGNA, Giovani; PAULA-GARCIA, Waynice Neiva de; SILVA, Joao ManoelBackground: Pain management plays an essential role in postoperative recovery after lung surgeries. The Erector Spinae Plane Block (ESPB) is a widely used regional anaesthesia technique; however, few clinical trials have compared this block to active control in thoracic surgeries. This study evaluated the non-inferiority of the analgesia provided by ESPB when compared to paravertebral block ( PVB) in lung surgeries. Methods: Randomised, active-controlled, blinded for patients and assessors, noninferiority trial. Patients who underwent unilateral lung surgeries were divided into two groups according to the regional anaesthesia technique-continuous ESPB or PVB at the T5 level. The primary outcome was to assess pain using a numerical rating scale (NRS) with a test of the interaction of three measures over 24 h postoperatively. An NRS score >= 7 was considered analgesia failure, and the prespecified non-inferiority margin was 10%. Results: In the interim analysis that terminated this study, 120 participants were enrolled. ESPB patients reported higher mean NRS general values over 24 h, 4.6 +/- 3.2 in the ESPB group versus 3.9 +/- 2.9 in the PVB group, with a difference of -0.67 (-15.2%) and 95%CI: -1.29 to -0.05 (p =.02), demonstrating not non-inferiority. In addition, the ESPB group presented higher NRS failure of analgesia over 24 h (p <.01) and required more postoperative opioids (p =.01 over 24 h). There was no difference in patient satisfaction between groups. Conclusion: This trial demonstrated that a continuous erector spinae plane block was not non-inferior to a continuous paravertebral block for analgesia after lung surgery but resulted in higher levels of postoperative pain and opioid consumption.
- Prediction of Extubation Failure in COVID-19(2021) ANDRADE FILHO, Pedro H. de; BRASIL, Eduardo S. de Assis; COSTA, Ladyer G.; SOUSA, Daniel Escossia M.; PEREIRA, Talison S.; JR, Joao Manoel SilvaBACKGROUND: S-pO2/F-IO2 may be a reliable noninvasive alternative to the P-aO2/F-IO2 index. Furthermore, the ROX index (ie, the ratio of S-pO2/F-IO2 to breathing frequency) has been validated to predict high-flow nasal cannula failure in subjects under spontaneous breathing. However, these indices have not been tested in subjects with COVID-19 receiving invasive mechanical ventilation. This study aims to verify the correlation between both the ROX index and S-pO2/F-IO2 with P-aO2/F-IO2 and the ratio of P-aO2/F-IO2 to breathing frequency, and to determine the accuracy of the indices that use S-pO2 for the prediction of extubation failure in subjects with COVID-19. METHODS: A prospective cohort study was conducted from May 15, 2020, to June 15, 2020, with subjects with COVID-19 on invasive mechanical ventilation. Indices using S-pO2 in the formula were compared to those using P-aO2. Additionally, the performance of the indices in predicting extubation failure was evaluated. RESULTS: This study included 69 subjects age 64.8 +/- 14.6 y. There were no differences between the median values of the indices, including between the ROX index and P-aO2/F-IO2 to breathing frequency (P = .40) or between P-aO2/F-IO2 and S-pO2/F-IO2 (P = .83). When comparing the ROX index with the P-aO2/F-IO2 index to breathing frequency, they were found to be strongly correlated (R-2 = 0.75 [95% CI 0.6763-0.8152], P < .001). The comparison of P-aO2/F-IO2 with S-pO2/F-IO2 revealed R-2 = 0.70 (95% CI 0.563-0.749, P < .001). The area under the receiver operating characteristic curve for the ROX index to determine extubation failure was 0.74 (P = .01), whereas for S-pO2/F-IO2 it was 0.78 (P < .001). CONCLUSIONS: The indices presented a good correlation in subjects with COVID-19 on invasive mechanical ventilation, and both the ROX index and S-pO2/F-IO2 can discriminate extubation failure in this population.
- Response to ""Is really a continuous erector spinae plane block inferior to a continuous paravertebral block for pain control following lung surgery?""(2024) ANDRADE FILHO, Pedro Hilton de; SILVA, Joao Manoel