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1.
J Perianesth Nurs ; 33(5): 699-707, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29428831

RESUMO

PURPOSE: The purpose of our study was to evaluate effective ischemia and its associated complications using the limb occlusion pressure technique versus standard pneumatic ischemia technique. DESIGN: Single-centered randomized, controlled clinical trial. METHODS: One hundred sixty participants were randomized into two equal and parallel groups: (1) intervention group-LOP technique, and (2) control group-standard pneumatic ischemia technique. FINDINGS: Anesthetic incidences (need to administer analgesics for pain and/or hypnotics for anxiety) were similar in both groups. Statistically significant differences were observed for pain, hyperemia, and hospitalization, with higher values in the control group. Patients in the intervention group had, at 95% confidence, a 2.9 times greater chance of having optimal ischemia (assessed as 9 on the analog scale) than patients in the control group (odds ratio, 2.9; 95% confidence interval, 1.4 to 6.1). CONCLUSIONS: Intervention group patients had lower indexes of hyperemia, pain, and hospital stay.


Assuntos
Hiperemia/epidemiologia , Dor/epidemiologia , Torniquetes , Extremidade Superior/cirurgia , Adulto , Idoso , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pressão , Extremidade Superior/irrigação sanguínea
2.
J Trauma Nurs ; 24(5): 326-334, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28885525

RESUMO

The objective of this research was to study the possible relationship between the consumption of dicoumarinic agents (understanding the consumption of acenocoumarol as regulated and monitored anticoagulation) and the mortality rate in people older than 65 years undergoing a hip fracture (HF) intervention. It was a retrospective, observational and descriptive study. Nine hundred fifty-seven patients were included who underwent an intervention for HF between the years 2012 and 2014 in a third-level hospital. Patients took acenocoumarol (16.1%), which compared with nonanticoagulated patients took longer in receiving intervention, they remained hospitalized for more days, and they presented greater mortality within the first year after the intervention. Likewise, those who presented greater risk according to the classification system used by the American Society of Anesthesiologists (ASA) to estimate the risk of anesthesia for the different states of the patients who were anticoagulated also suffered greater mortality. The next factors increased the mortality in the first year: advanced age, delayed surgery, male sex, need for transfusion, high international normalized ratio, consumption of acenocoumarol, and a high ASA risk. We concluded the consumption of acenocoumarol increased the risk of mortality within the first year after surgery in 1.3 of possible cases. Other risk factors that also independently increased the risk of mortality included advanced age, male sex, delayed surgery, the need for transfusions, and surgical risk (for high levels in the ASA classification).


Assuntos
Anticoagulantes/efeitos adversos , Causas de Morte , Fixação Interna de Fraturas/métodos , Fraturas do Quadril/mortalidade , Fraturas do Quadril/cirurgia , Acenocumarol/administração & dosagem , Acenocumarol/efeitos adversos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/administração & dosagem , Estudos de Coortes , Feminino , Seguimentos , Fixação Interna de Fraturas/mortalidade , Avaliação Geriátrica , Fraturas do Quadril/diagnóstico , Fraturas do Quadril/tratamento farmacológico , Humanos , Tempo de Internação , Masculino , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Taxa de Sobrevida , Resultado do Tratamento
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