RICARDO VIEIRA CARLOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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bookPart Componentes dos Aparelhos de Anestesia(2021) TORRES, Marcelo Luis Abramides; CARLOS, Ricardo Vieira- The effect of prior tetanic stimulation on train-of-four monitoring in paediatric patients A randomised open-label controlled trial(2017) CARLOS, Ricardo V.; BOER, Hans Donald de; TORRES, Marcelo Luis Abramides; CARMONA, Maria Jose CarvalhoBACKGROUND In clinical research, neuromuscular monitoring must present a stable response for a period of 2 to 5 min before administration of a neuromuscular blocking agent. The time required to reach this stable response may be shortened by applying a 5-s tetanic stimulus. OBJECTIVES The aim of this study was to test whether tetanic stimulation interferes with onset and recovery times after a single dose of rocuronium 0.6 mg kg(-1) followed by spontaneous recovery. DESIGN A randomised, open-label, controlled trial. SETTING A single-centre trial, study period from January 2014 to July 2015. PATIENTS Fifty children aged 2 to 11 years scheduled for elective paediatric surgery. INTERVENTION Patients were randomly allocated to receive either tetanic stimulation (group T) or not (group C) before calibration of the neuromuscular monitor. MAIN OUTCOME MEASURES Onset and recovery times. Initial and final T1 height, time to obtain initial T1 height stability and monitor settings were also analysed. RESULTS There was no significant difference in mean onset time [(C: 57.5 (+/- 16.9) vs. T: 58.3 (+/- 31.2) s; P = 0.917]. Mean times to normalised train-of-four (TOF) ratios of 0.7, 0.8 and 0.9 were significantly shorter in the tetanic stimulation group [C: 40.1 (+/- 7.9) vs. T: 34.8 (+/- 10) min; P = 0.047, C: 43.8 (+/- 9.4) vs. T: 37.4 (+/- 11) min; P = 0.045 and C: 49.9 (+/- 12.2) vs. T: 41.7 (+/- 13.1) min; P = 0.026, respectively]. The mean time required for T1 height stabilisation was similar in the two groups [C: 195.0 (+/- 203.0) vs. T: 116.0 (+/- 81.6) s; P = 0.093], but the initial and final T1 height values were significantly lower in the tetanic stimulation group (C: 98.0 vs. T: 82.7%; P<0.001 and C: 95.3 vs. T: 69.3%; P<0.001, respectively). CONCLUSION Tetanic stimulation shortened the mean times to normalised TOF ratios of 0.7, 0.8 and 0.9, but there was no difference in the mean onset time or the mean time required for T1 height stabilisation after a single dose of rocuronium 0.6 mg kg(-1) followed by spontaneous recovery in children aged 2 to 11 years.
bookPart Princípios físico-químicos aplicados à anestesiologia(2017) TORRES, Marcelo Luis Abramides; CARLOS, Ricardo VieirabookPart Equipamentos Eletromédicos na Sala de Cirurgia(2021) TORRES, Marcelo Luis Abramides; CARLOS, Ricardo Vieira- Is there still an indication for the use of succinylcholine in cesarean section? The answer is no(2017) CARLOS, Ricardo Vieira; TORRES, Marcelo Luis Abramides; BOER, Hans Donald de
- Train-of-four recovery precedes twitch recovery during reversal with sugammadex in pediatric patients: A retrospective analysis(2018) CARLOS, Ricardo Vieira; TORRES, Marcelo Luis Abramides; BOER, Hans Donald deBackgroundAfter reversal of a rocuronium-induced neuromuscular blockade with sugammadex, the recovery of train-of-four ratio to 0.9 is faster than recovery of first twitch of the train-of-four to 90% in adults. These findings after reversal of neuromuscular blockade with sugammadex have not yet been investigated in pediatric patients. AimsThe aim of this retrospective analysis was to investigate the relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio after reversal of rocuronium-induced neuromuscular blockade with sugammadex in pediatric patients. MethodsPatients ASA I-III, aged 2-11years, and who underwent abdominal and/or perineal surgery were included in the analysis. After extracting the necessary data from the hospital database, the patients were divided into 2 groups based on the dose of sugammadex received: group A: 2mg.kg(-1) for reversal of moderate neuromuscular blockade and group B: 4mg.kg(-1) for reversal of deep neuromuscular blockade. The relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio in these 2 groups were analyzed. ResultsData from 43 pediatric patients aged 2-11years could be analyzed. The first twitch of the train-of-four height at the recovery of train-of-four ratio to 0.9 in group B was statistically significantly lower compared with group A. This height 3 and 5minutes after the train-of-four ratio reached 0.9 showed no statistically significant differences between groups. ConclusionThe results were in line with the results found in adults and showed that the train-of-four ratio recovered to 0.9 was faster than first twitch of the train-of-four height recovered to the same level.
- Reversal of neuromuscular block with sugammadex in five heart transplant pediatric recipients(2018) CARLOS, Ricardo Vieira; TORRES, Marcelo Luis Abramides; BOER, Hans Donald deHeart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block. Several reports described that cholinesterase inhibitors drugs, like neostigmine, may produce a dose-dependent life-threatening bradycardia in heart transplant recipients while other publication described the safe use of neostigmine. Reversal of neuromuscular block with sugammadex is another possibility, but limited data exists in literature. We describe five cases in which successful reversal of neuromuscular block was performed with sugammadex in heart transplant pediatric recipients without sequelae and discuss the reversal of neuromuscular block in this patient population. (C) 2018 Sociedade Brasileira de Anestesiologia.
bookPart Equipamentos eletromédicos na sala de cirurgia(2017) TORRES, Marcelo Luis Abramides; CARLOS, Ricardo VieirabookPart Princípios Físico-químicos Aplicados à Anestesiologia(2021) TORRES, Marcelo Luis Abramides; CARLOS, Ricardo Vieira- Rocuronium and sugammadex in a 3 days old neonate for draining an ovarian cyst. Neuromuscular management and review of the literature(2016) CARLOS, Ricardo Vieira; TORRES, Marcelo Luis Abramides; BOER, Hans D. deA case is reported in which a 3-days old neonate with a giant ovarian cyst was scheduled for surgery. The patient received a dose of sugammadex to reverse a rocuronium-induced neuromuscular block. A fast and efficient recovery from neuromuscular block was achieved within 90 s. No adverse events or other safety concerns were observed. Furthermore, a review of the literature on the use of sugammadex in neonates was performed. (C) 2015 Sociedade Brasileira de Anestesiologia.