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dc.contributor.authorMoreira, Rodrigo Mencalha
dc.date.accessioned2023-12-21T18:57:56Z-
dc.date.available2023-12-21T18:57:56Z-
dc.date.issued2016-04-28
dc.identifier.citationMOREIRA, Rodrigo Mencalha. Avaliação morfológica, eletromiográfica e por termografia infravermelha do bloqueio do plexo braquial em coelhos guiado por ultrassonografia. 2016. 79 f. Tese (Doutorado em Medicina Veterinária, Patologia e Ciências Clínicas) - Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropédica - RJ, 2016.por
dc.identifier.urihttps://rima.ufrrj.br/jspui/handle/20.500.14407/10143-
dc.description.abstractO bloqueio do plexo braquial (BPB) permanece como um dos temas mais intrigantes da anestesia contemporânea, pois, devido a complexa organização desta estrutura, está associado a um número expressivo de insucessos. Com o estudo objetivou-se avaliar a eficácia do bloqueio do BPB guiado por ultrassonografia associado a estimulação de nervos periférico em coelhos. Inicialmente foram dissecados 80 plexos braquiais, de 40 cadáveres, de modo a capacitar os pesquisadores na anatomia macroscópica da região. Posteriormente, no estudo in vivo, foram utilizados 40 coelhos do sexo masculino os quais foram aleatoriamente alocados em dois grupos experimentais: Grupo 1: BPB guiado por ultrassonografia associado a estimulação de nervos periféricos (US/ENP); Grupo 2: BPB guiado por estimulação de nervos periférivos (ENP). Sob anestesia geral, o BPB foi realizado, por via axilar, através da injeção de lidocaína 2% sem vasoconstrictor, na dose máxima de 0,7ml.kg-1. A diferença entre o tempo de latência motora, tempo de bloqueio motor e do volume necessário para o BPB entre as técnicas foram avaliadas através da gravação dos potenciais de ação motores compostos do nervo radial. A mensuração da temperatura cutânea (TC), por termografia infravermelha, foi realizada em áreas de interesse (AIEs), previamente estipuladas, nas mãos, dígitos e antebraços, de modo a verificar a correlação de sua variação com a eficácia do BPB. Em 92,5% dos animais os nervos resultantes foram constituídos das conexões entre os ramos ventrais dos 4 últimos nervos espinhais cervicais (C5, C6, C7, C8) e o primeiro torácico (T1). Não houve diferença significativa no tempo de performance do BPB guiado por US/ENP (4,3 ± 0,73 min) ou por ENP (6,4 ± 0,68 min), no entanto, foi necessário a administração de um volume significativamente menor de anestésico local no grupo guiado por US/ENP (0,61 ± 0,15 ml versus 1,22 ± 0,17; P < 0,0001). Apesar do menor volume utilizado, observou-se que o grupo US/ENP apresentou menor tempo para instalação do bloqueio (1,1 ± 0,45) em comparação ao grupo ENP (1,95 ± 0,79; P < 0,01). O BPB guiado por US/ENP ou por ENP resultou em um aumento substancial e significativo da TC nas AIEs dos nervos radial, musculocutâneo ulnar e mediano (P < 0,001), no entanto, este aumento foi mais contudente na região da mão e dígitos. Nas AIEs dos nervos radial, mediano e ulnar na região dorsolateral das mãos, foram observadas as maiores variações de temperatura no grupo US/ENP em comparação ao ENP (radial 3,1 versus 2,0oC; mediano 4,5 versus 3,1 oC e ulnar 4,1 versus 3,6 oC). Dessa forma conclui-se que o BPB guiado por US/ENP é uma técnica eficaz e de fácil reprodutibilidade no modelo experimental utilizado a qual requereu menor volume de anestésico local, proporcionou menor tempo de latência motora e maior tempo de bloqueio motor quando comparado ao bloqueio guiado por ENP. O aumento da TC é uma ferramenta altamente eficaz na avaliação da eficácia do BPB com valor preditivo, sensibilidade e especificidade de 100%. Outrossim,futuros estudos clínicos são necessários para verificar sua correlação com a área anestesiada.por
dc.description.sponsorshipFundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro - FAPERJpor
dc.formatapplication/pdf*
dc.languageporpor
dc.publisherUniversidade Federal Rural do Rio de Janeiropor
dc.rightsAcesso Abertopor
dc.subjectBrachial plexuseng
dc.subjectUltrasonographyeng
dc.subjectPlexo braquialpor
dc.subjectUltrassonografiapor
dc.subjectTermografiapor
dc.subjectTermographypor
dc.titleAvaliação morfológica, eletromiográfica e por termografia infravermelha do bloqueio do plexo braquial em coelhos guiado por ultrassonografiapor
dc.title.alternativeMorphological, electromyography and infrared thermal imaging evaluation of the ultrassound-guided brachial plexus block in rabbitseng
dc.typeTesepor
dc.description.abstractOtherThe brachial plexus block (BPB) remains one of the most intriguing topics of contemporary anesthesia because, due to the complex organization of this structure is associated with a significant number of failures. The aim of this study was to evaluate the effectiveness of ultrasound-guided associated with peripheral nerve stimulation BPB in rabbits. Initially, 80 plexus were dissected, so as to enable researchers in the gross anatomy of the region. Later, in the in vivo study, we used 40 male rabbits which were randomly divided into two groups: Group 1: Ultrasound-guided associated with peripheral nerve stimulation (US/ENP) BPB; Group 2: Peripheral nerve stimulation-guided (ENP) BPB. Under general anesthesia, axillary BPB was performed, under lidocaine 2% without vasoconstrictor injection at the maximum dose of 0,7ml.kg-1. The motor latency, motor block and volume difference between the BPB between the techniques were evaluated by recording motor action potentials compounds of the radial nerve. The measurement of skin temperature (ST), by infrared thermography, was carried out in areas of interest, previously stipulated in the forepaw, digits and forearm, in order to verify the correlation of the variation in the effectiveness of BPB. In 92.5% of the animals the nerves resulting consisted of connections between the ventral rami of the last four cervical spinal nerves (C5, C6, C7, C8) and first thoracic (T1). No significant difference was observed in time performance of US/ENP-guided BPB (4.3 ± 0.73 min) or ENP-guided BPB (6.4 ± 0.68 minutes), however, significantly less volume administration was necessary to local anesthetic in the US/ENP-guided BPB (0.61 ± 0.15 mL vs 1.22 ± 0.17; P <0.0001). Despite the lower volume used, it was observed that the US/ENP group had shorter on set time block (1.1 ± 0.45) compared to ENP group (1.95 ± 0.79; P <0.01). The US/ENP-guided BPB or ENP-guided BPB resulted in a substantial and significant increase in ST areas of interest in the radial, musculocutaneous, median and ulnar nerves (P < 0.001), however this increase was outstanding in hand and digits regions Thus it is concluded that the US/ENP-guided BPB is an effective and easy technique to reproduce in this experimental model which required lower volume of local anesthetic, provided a smaller motor latency and a higher motor blockade time when compared to the ENP-guided BPB. The increase in ST is a highly effective tool for assessing the effectiveness of BPB with predictive value, sensitivity and specificity of 100%. Furthermore, future clinical studies are needed to verify its correlation with the anaesthetized area.eng
dc.contributor.advisor1Figueiredo, Marcelo Abidu
dc.contributor.advisor1ID986.393.587-53por
dc.contributor.advisor1Latteshttp://lattes.cnpq.br/0514197225370792por
dc.contributor.advisor-co1Otero, Pablo Ezequiel
dc.contributor.advisor-co1Latteshttp://lattes.cnpq.br/2699593202605569por
dc.contributor.referee1Sampaio, Marco Aurélio Pereira
dc.contributor.referee2Souza, Diogo Benchimol de
dc.contributor.referee3Santos, Paulo Sergio Patto dos
dc.contributor.referee4Figueiredo, Nubia Verçosa
dc.creator.ID8438065759por
dc.creator.Latteshttp://lattes.cnpq.br/5427334834841231por
dc.publisher.countryBrasilpor
dc.publisher.departmentInstituto de Veterináriapor
dc.publisher.initialsUFRRJpor
dc.publisher.programPrograma de Pós-Graduação em Medicina Veterinária (Patologia e Ciências Clínicas)por
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dc.originais.urihttps://tede.ufrrj.br/jspui/handle/jspui/1473
dc.originais.provenanceSubmitted by Sandra Pereira (srpereira@ufrrj.br) on 2017-03-22T12:11:48Z No. of bitstreams: 1 2016 - Rodrigo Mencalha Moreira.pdf: 28440057 bytes, checksum: 791e667a1aa1132fd32db5ed549faf27 (MD5)eng
dc.originais.provenanceMade available in DSpace on 2017-03-22T12:11:48Z (GMT). No. of bitstreams: 1 2016 - Rodrigo Mencalha Moreira.pdf: 28440057 bytes, checksum: 791e667a1aa1132fd32db5ed549faf27 (MD5) Previous issue date: 2016-04-28eng
Appears in Collections:Doutorado em Medicina Veterinária (Patologia e Ciências Clínicas)

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