ELKE FRERICHS LACAVA PAGNOCCA

Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
SVANES-62, Hospital Universitário

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  • article 3 Citação(ões) na Scopus
    Predictors of pain and prolonged length of stay after orthognathic surgery: A retrospective cohort study
    (2015) SHINAGAWA, Adriana; MELHEM, Fernando Elias; DE CAMPOS, Antônio Carlos; DIAS CICARELLI, Domingos; FRERICHS, Elke
    Introduction: Orthognathic treatment has assumed an important role in orthodontics and maxillofacial surgery in the last years; however, little has been investigated about this type of treatment. Objectives: The main purpose of this study was to identify major factors and/or predictors associated with postoperative pain (PP) and hospital length of stay (LOS) after orthognathic surgery. Materials and methods: 52 patients who underwent orthognathic surgery from 2008 to 2010 at the University Hospital of São Paulo University were investigated. Study variables such as patient characteristics, preoperative, intraoperative and postoperative data were collected. The outcome variables were PP and LOS. Descriptive and analytical statistics was computed for all variables. Results: 27.6% of patients had pain in the postoperative period. Lidocaine used in general anesthesia was an associated factor of PP. The overall mean LOS was 2 days; gender, location of procedure, type and duration of anesthesia were identified as probable predisposing factors. There was a significant correlation between anesthesia time and discharge. Anesthesia variables were more predictably related with postoperative pain and hospitalization time. Location of orthognathic procedure, however, was an important surgical variable that influenced in LOS. Conclusions: Intravenous lidocaine boluses used during general anesthesia were associated with PP. Male patients, single-jaw surgery, inhalational anesthesia and duration of anesthesia were predisposing factors that improve LOS.
  • article 22 Citação(ões) na Scopus
    Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens
    (2011) YAMAGUCHI, E. T.; CARDOSO, M. M.; TORRES, M. L.; NASCIMENTO, R. C.; RIBEIRO, M. C.; FRERICHS, E.; PAYEN, D.
    Background: The aim of this study was to determine serum oxytocin concentrations following different regimens of prophylactic oxytocin administration in women undergoing elective caesarean delivery. Methods: Thirty healthy pregnant patients were randomized, after clamping of the umbilical cord, to receive intravenous oxytocin in one of the following groups: G1 (n = 9), 10 IU of oxytocin infused over 30 min (0.33 IU/min); G2 (n = 11), 10 IU of oxytocin infused over 3 min and 45 s (2.67 IU/min); and G3 (n = 10), 80 IU of oxytocin infused over 30 min (2.67 IU/min). Both patient and surgeon were blinded to allocation. Uterine tone was assessed by surgical palpation. Serum oxytocin concentration was determined by enzyme immunoassay before anaesthesia (T0) and at 5 (T5), 30 (T30) and 60 (T60) min after the start of oxytocin infusion. Results: Serum oxytocin concentrations (mean standard error, ng/mL) were not significantly different in the groups at T0 (0.06 +/- 0.02, 0.04 +/- 0.02 and 0.07 +/- 0.04, respectively, P = 0.76), and T60 (0.65 +/- 0.26, 0.36 +/- 0.26 and 0.69 +/- 0.26, respectively, P = 0.58). G3 showed higher concentrations than G1 at 15 (3.65 +/- 0.74 versus 0.71 +/- 0.27, P = 0.01) and at T30 (6.19 +/- 1.19 versus 1.17 +/- 0.37, P < 0.01), and were higher than G2 at T30 (6.19 +/- 1.19 versus 0.41 +/- 0.2, P < 0.01). Haemodynamic data and uterine tone were considered satisfactory and similar in all groups. No additional uterotonic agents were needed. Conclusion: Serum oxytocin measurements made using enzyme immunoassay in healthy pregnant women undergoing elective caesarean delivery showed that administration of 80 IU oxytocin over 30 min resulted in higher serum oxytocin levels after 5 and 30 min than the two other regimens. The concentrations did not differ between groups at 60 min.
  • article 1 Citação(ões) na Scopus
    Effect of flumazenil on recovery from general anesthesia with isoflurane: A randomized controlled trial
    (2016) DIAS CICARELLI, Domingos; ROJAS-ÁLVAREZ, Nora Elizabeth; FULLER, Priscila; LACAVA PAGNOCCA, Marcelo; FRERICHS, Elke; MARTINS BENSENOR, Fábio Ely
    Background and objectives: The inhalational anesthetic isoflurane is widely used in general anesthetics. Its mechanism of action involves interaction with the receptor of gamma-aminobutyric acid (GABA), which is also the binding site for benzodiazepines. Flumazenil, benzodiazepine antagonist, reverses the effects of these drugs in GABA receptors and could therefore also reverse the effect of isoflurane. In anesthesia practice, extubation and early anesthetic recovery reduce morbidity and incidence of complications. The objective of this trial is to determine whether the use of lumazenil may contribute to faster recovery from anesthesia. Methods: Forty patients scheduled to undergo general anesthesia with isolurane were enrolled in this prospective, double-blind, randomized trial. Patients were randomized to receive, at the end of anesthesia, lumazenil or placebo as allocated into two groups. The anesthetic technique was standardized. The groups were compared concerning values of cerebral state index (CSI), heart rate, blood pressure and oxygen saturation from the application of flumazenil or placebo until 30 min after injection. Data regarding time to extubation, time to reach 10 points in the Aldrete-Kroulic score (AK = 10) and Vigilance score (VS = 10) was also collected. ANOVA test was applied to analyze the results, considering p < 0.05. Results:Patients receiving flumazenil achieved faster extubation than the control (p = 0.033). No differences were observed in values of CSI, the time until AK = 10 and until VS = 10. Conclusions: Administration of lumazenil at the end of isolurane general anesthesia resulted in earlier extubation in studied patients.