LUCIANA CHAVES DE MORAIS
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
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- 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 AdelBACKGROUND 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.
- Aprepitant as a fourth antiemetic prophylactic strategy in high-risk patients: a double-blind, randomized trial(2018) MORAIS, L. C. de; SOUSA, A. M.; FLORA, G. F.; GRIGIO, T. R.; GUIMARAES, G. M. N.; ASHMAWI, H. A.BackgroundPost-operative nausea and vomiting (PONV) is one of the most important causes of patient discomfort after laparoscopic surgeries despite the use of a multimodal pharmacological approach. This study assessed whether the addition of aprepitant to a multimodal regimen would further decrease the incidence of PONV in high-risk patients. MethodsApfel-score three or four patients, scheduled for laparoscopic procedures to treat abdominal or pelvic cancer, were randomized to receive oral starch (control group) or 80 mg of oral aprepitant (treatment group) before induction of anaesthesia in a double-blind study. All patients received 4-8 mg of intravenous dexamethasone (at induction) and 4-8 mg of ondansetron (at the end) and a standardized total intravenous anaesthesia (TIVA) technique combined with neuraxial blockade. PONV was defined as any episode of nausea, vomiting or retching in the first 24 h after anaesthesia. ResultsSixty-six patients completed the study. Vomiting occurred in 13/32 (40.6%) patients in the control group and in 1/34 (2.9%) patients in the treatment group (P = 0.0002, 95%CI: 18-54%) in the first 24 h after anaesthesia. Severe nausea occurred in two (6.3%) patients, and severe vomiting occurred in four (12.5%) patients in the control group. One patient presented with severe vomiting in the treatment group in the first 24 post-operative hours. ConclusionEighty milligrams of aprepitant added to a three-drug multimodal prophylaxis strategy can bring benefits to a high-risk population by reducing PONV episodes and rescue antiemetic requirements. This study was registered in the ClinicalTrials.gov (NCT 02357693) database.
conferenceObject Addiction of neurokinin 1 receptor antagonist aprepitant to double antiemetic prophylaxis improves control of postoperative nausea and vomiting in oncologic patients undergoing laparoscopic procedures: a double-blinded randomized controlled trial(2014) SOUSA, A. M.; MORAIS, L. Chaves de; GUIMARAES, G. Magalhaes Nunes; FLORA, G. Fagundes; ASHMAWI, H. Adel