Repository logo

Browsing by Author "Gomes, Blandina"

Now showing 1 - 2 of 2
  • Escore CR‐POSSUM e Índice de Apgar Cirúrgico como fatores preditivos para a alocação de pacientes após cirurgia colorretal
    Publication . Pinho, Sílvia; Lagarto, Filipa; Gomes, Blandina; Costa, Liliana; Nunes, Catarina S.; Oliveira, Carla
    Surgical patients frequently require admission in high-dependency units or intensive care units. Resources are scarce and there are no universally accepted admission criteria, so patients' allocation must be optimized. The purpose of this study was to investigate the relationship between postoperative destination of patients submitted to colorectal surgery and the scores ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) and Surgical Apgar Score (SAS) and, secondarily find cut-offs to aid this allocation.
    2018-04-01Journal article Open access Show more
  • Incidence of postoperative residual neuromuscular blockade: a multicenter, observational study in Portugal (INSPIRE 2)
    Publication . Esteves, Simão; Barros, Filinto Correia de; Nunes, Catarina S.; Puga, Andreia; Gomes, Blandina; Abelha, Fernando; Machado, Humberto; Ferreira, Milene; Fernandes, Nuno; Vítor, Paula; Pereira, Sandra; Lapa, Teresa A.; Oliveira, Vítor Pinho
    Background: Although the use of neuromuscular blocking agents (NMBAs) optimizes surgical conditions and facilitates tracheal intubation, it can lead to residual neuromuscular blockade (RNMB), with postoperative complications. This study aimed to assess RNMB incidence and management in Portugal. Methods: Prospective observational study of patients admitted for elective surgery requiring general anesthesia with nondepolarizing NMBAs between July 2018 and July 2019 at 10 Portuguese hospitals. The primary endpoint was the proportion of patients arriving at postanesthesia care unit (PACU) with a TOF ratio ,0.9. Results: A total of 366 patients were included, with a median age of 59 years, and 89.1% classified as ASA II or III. Rocuronium was the most used NMBA (99.5%). A total of 96.2% of patients received a reversal agent, 96.6% of which sugammadex and 3.4% neostigmine. Twenty patients displayed a TOF ratio ,0.9 at PACU arrival, representing an RNMB incidence of 5.5% (95% CI, 3.1%–7.8%). Only two patients displayed a TOF ratio ,0.7. RNMB incidence was 16.7% with neostigmine and 5.3% with sugammadex (P 5 .114). In patients with intraoperative neuromuscular blockade (NMB) monitoring, RNMB incidence was 5% (95% CI, 2%–8%), which varied significantly according to the type of monitoring (P 5 .018). Incidence of adverse events was 3.3% (2 severe and 10 moderate). Conclusions: The reported overall incidence of 5.5% is numerically lower than results from similar observational studies. An appropriate pharmacological neuromuscular reversal strategy, guided by quantitative neuromuscular monitoring, has the potential to achieve even better results, converting RNMB from an unusual to a very rare or even inexistent event.
    2023Journal article Open access Show more