Exploring the Potential of Lidocaine in a Bilateral Erector Spinae Plane Block for Multimodal Analgesia in Partial Hepatectomy: A Case Report.

The bilateral erector spinae plane block (ESP) has been effectively used for abdominal surgery, and the placement of catheters is known to extend the benefits of the block while allowing for the adjustment of local anesthetic doses as necessary. Since fascial plane blocks require high volumes of local anesthetic and a prolonged duration of effect, typically, long-acting local anesthetics are preferred. However, lidocaine is not commonly chosen for these types of blocks due to the large volumes required and the associated risk of local anesthetic systemic toxicity. Nonetheless, we present a case report of a patient who underwent a partial hepatectomy under general anesthesia, with perioperative placement of a bilateral ESP block. Bilateral catheters were inserted, and 1% lidocaine was selected as the local anesthetic due to resource limitations. The surgery proceeded without complications, and the patient reported effective analgesia and a high level of satisfaction. Our report suggests that the utilization of lidocaine in a continuous ESP block can be a successful alternative for partial hepatectomies.

Malária no Amazonas: registros e memórias / Malaria in Amazonas: records and memories

O registro histórico realizado por meio de pesquisa literária e documental nas instituições envolvidas no controle da malária, associado ao relato das vivências profissionais dos autores do livro,traz aos leitores desta publicação um conhecimento riquíssimo das características epidemiológicas e do controle da malária no Estado do Amazonas ao longo das últimas décadas. A experiência vivida intensamente pelos autores no combate à doença, tanto na Campanha de Erradicação da Malária - CEM como posteriormente na Sucam, e mais recentemente na Fundação Nacional de Saúde - Funasa, mostra as dificuldades enfrentadas e como têm sido superadas.(AU)

Malária no Amazonas: registros e memórias

O registro histórico realizado por meio de pesquisa literária e documental nas instituições envolvidas no controle da malária, associado ao relato das vivências profissionais dos autores do livro,traz aos leitores desta publicação um conhecimento riquíssimo das características epidemiológicas e do controle da malária no Estado do Amazonas ao longo das últimas décadas. A experiência vivida intensamente pelos autores no combate à doença, tanto na Campanha de Erradicação da Malária - CEM como posteriormente na Sucam, e mais recentemente na Fundação Nacional de Saúde - Funasa, mostra as dificuldades enfrentadas e como têm sido superadas.

Historical analysis of the records of sylvan yellow fever in the State of Amazonas, Brazil, from 1996 to 2009.

INTRODUCTION: Yellow fever is a non-contagious infectious disease, highly lethal, transmitted by the Aedes, Haemagogus and Sabethes. METHODS: Descriptive retrospective study of the yellow fever cases in Amazonas, between 1996 and 2009. RESULTS: Forty two cases of yellow fever were confirmed, with 30 deaths, 10% of which were foreigners. CONCLUSIONS: The presence of Aedes aegypti and Aedes albopictus in both rural Amazonas and its capital demonstrates the dispersion of these vectors and underscores the need for better and continuous epidemiological and entomological control.

Historical analysis of the records of sylvan yellow fever in the State of Amazonas, Brazil, from 1996 to 2009

Introduction Yellow fever is a non-contagious infectious disease, highly lethal, transmitted by the Aedes, Haemagogus and Sabethes. Methods Descriptive retrospective study of the yellow fever cases in Amazonas, between 1996 and 2009. Results Forty two cases of yellow fever were confirmed, with 30 deaths, 10% of which were foreigners. Conclusions The presence of Aedes aegypti and Aedes albopictus in both rural Amazonas and its capital demonstrates the dispersion of these vectors and underscores the need for better and continuous epidemiological and entomological control. .

[Urban expansion and spatial distribution of malaria in the municipality of Manaus, State of Amazonas]. / Expansão urbana e distribuição espacial da malária no município de Manaus, Estado do Amazonas.

In the municipality of Manaus, intensification of the migratory process, along with precarious epidemiological and entomological surveillance, resulted in reintroduction of malaria transmission on the urban perimeter (in the eastern zone), in July 1988, after 13 years without any records of autochthonous disease. This study reports on the epidemiological situation relating to malaria and to the areas that were subjected to human actions (deforestation, human settlement, fish-rearing activity, etc) in Manaus, between 1986 and 2005. In this municipality, the population increase from 1986 to 2005 was 105.2%. This resulted from occupation of space, in the form of invasions and housing projects. From 2003, the increase in relation to 1986 was more than 2,000%. In these areas, there were increases in disease incidence. The annual parasitic index in the municipality ranged from low to medium risk and, between urban zones, it ranged from no risk to high risk. In the eastern, western and northern zones, which still contain areas with agricultural characteristics, there was greater receptivity and vulnerability to transmission.

Expansão urbana e distribuição espacial da malária no município de Manaus, Estado do Amazonas / Urban expansion and spatial distribution of malaria in the municipality of Manaus, State of Amazonas

No município de Manaus, a intensificação do processo migratório, aliada a precária vigilância epidemiológica e entomológica, resultou na reintrodução da transmissão de malária no perímetro urbano, zona Leste, em julho de 1988, após 13 anos sem registro de autoctonia. Este estudo descreve sobre a situação epidemiológica da malária e áreas que sofreram ações antrópicas (desmatamento, assentamentos humanos, atividades de piscicultura, etc.) em Manaus, no período entre 1986 e 2005. Nesse Município, o incremento populacional em 2005 atingiu 105,2 por cento, em relação a 1986, resultado de ocupação dos espaços (invasões e conjuntos habitacionais). A partir de 2003, a doença teve incremento acima 2.000 por cento em relação a 1986. Nessas áreas ocorreu aumento da incidência da doença. O índice parasitário anual no Município oscilou de baixo a médio risco, e entre as zonas urbanas, variou de sem risco a alto risco. As zonas Leste, Oeste e Norte onde ainda existem áreas com características rurais apresentaram maior receptividade e vulnerabilidade de transmissão.

In the municipality of Manaus, intensification of the migratory process, along with precarious epidemiological and entomological surveillance, resulted in reintroduction of malaria transmission on the urban perimeter (in the eastern zone), in July 1988, after 13 years without any records of autochthonous disease. This study reports on the epidemiological situation relating to malaria and to the areas that were subjected to human actions (deforestation, human settlement, fish-rearing activity, etc) in Manaus, between 1986 and 2005. In this municipality, the population increase from 1986 to 2005 was 105.2 percent. This resulted from occupation of space, in the form of invasions and housing projects. From 2003, the increase in relation to 1986 was more than 2,000 percent. In these areas, there were increases in disease incidence. The annual parasitic index in the municipality ranged from low to medium risk and, between urban zones, it ranged from no risk to high risk. In the eastern, western and northern zones, which still contain areas with agricultural characteristics, there was greater receptivity and vulnerability to transmission.