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
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- 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.
- Association between adult and child behavioral interactions with preoperative anxiety and emergence delirium(2023) QUINTAO, Vinicius Caldeira; CARLOS, Ricardo Vieira; KULIKOWSKI, Leslie Domenici; LEE-ARCHER, Paul; CARMONA, Maria Jose Carvalho
- First Brazilian pediatric hospital to adopt 1-hour preoperative fasting time for clear fluids for elective surgeries(2021) CARDOSO, Priscilla Ferreira Neto; QUINTAO, Vinicius Caldeira; PERINI, Bruno; CARMONA, Maria Jose Carvalho; CARLOS, Ricardo Vieira; SIMOES, Claudia Marquez
- Comparison of intravenous and inhalation anesthesia on postoperative behavior changes in children undergoing ambulatory endoscopic procedures: A randomized clinical trial(2023) QUINTAO, Vinicius Caldeira; CARLOS, Ricardo Vieira; CARDOSO, Priscilla Ferreira Neto; ZEFERINO, Suely Pereira; KULIKOWSKI, Leslie Domenici; LEE-ARCHER, Paul; CARMONA, Maria Jose CarvalhoBackgroundEarly and delayed behavioral changes are well recognized after anesthesia. Intravenous anesthesia may prevent emergence delirium. However, it has not been evaluated as a preventive strategy for delayed postoperative behavior changes. AimsWe aimed to determine whether intravenous anesthesia is effective at reducing postoperative behavior changes in children undergoing ambulatory endoscopic procedures when compared to inhalation anesthesia. MethodsThis randomized, double-blinded controlled trial was approved by the local IRB. Children aged 1-12 years who underwent ambulatory endoscopic procedures were recruited. Preoperative anxiety was evaluated through the modified Yale Preoperative Anxiety Scale. All children underwent face mask inhalation induction with sevoflurane. After a peripheral line was placed, each child was allocated to sevoflurane or propofol maintenance. Emergence delirium was evaluated through the Pediatric Anesthesia Emergence Delirium scale. The child was discharged home, and behavioral changes were assessed through the Posthospitalization Behavior Questionnaire for Ambulatory Surgery on Days 1, 7, and 14. ResultsOverall, 175 children were enrolled. On Day 1 after the procedure, 57 children presented at least one negative behavior. On Days 7 and 14, 49 and 44 children presented at least one negative behavior, respectively. The median number of negative behaviors was similar between the groups. Post hoc analyses showed a moderate correlation between emergence delirium and negative postoperative behavior on Day 7 (r = .34; p = <.001) and an increase of 3.31 (95% CI 1.90; 4.36 p < .001) points in the mean summed score of new negative behaviors for individuals with emergence delirium. ConclusionThe incidence of postoperative behavior changes in children undergoing ambulatory endoscopic procedures was similar when comparing intravenous with inhalation anesthesia. Children who experience emergence delirium might show a greater incidence of negative postoperative behavior changes.
conferenceObject Investigation of the DNA methylation profile in children presenting emergence delirium(2021) QUINTAO, Vinicius; CARLOS, Ricardo; KULIKOWSKI, Leslie; CARMONA, Maria