RESUMO
Stroke, or cerebrovascular accident (CVA), is a medical emergency that may lead to permanent neurological damage, complications, and death. The rapid loss of brain function due to disruption of the blood supply to the brain is caused by blockage (thrombosis, arterial embolism) or hemorrhage. The incidence of CVA during anesthesia for noncardiac nonvascular surgery is as high as 1% depending on risk factors. Comprehensive preoperative assessment and good perioperative management may prevent a CVA. However, should an ischemic event occur, appropriate and rapid management is necessary to minimize the deleterious effects caused to the patient. This case report describes a patient who had an ischemic CVA while under general anesthesia for dental alveolar surgery and discusses the anesthesia management.
Assuntos
Anestesia Dentária , Anestesia Geral , Estenose das Carótidas/complicações , Complicações Intraoperatórias , Procedimentos Cirúrgicos Bucais , Acidente Vascular Cerebral/etiologia , Adulto , Alveoloplastia/métodos , Arritmia Sinusal/etiologia , Bradicardia/etiologia , Isquemia Encefálica/etiologia , Eletroencefalografia/métodos , Feminino , Humanos , Hipotensão/etiologia , Intubação Intratraqueal/métodos , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Extração Dentária/métodos , Complexos Ventriculares Prematuros/etiologiaRESUMO
Self-powered implantable medical electronic devices that harvest biomechanical energy from cardiac motion, respiratory movement and blood flow are part of a paradigm shift that is on the horizon. Here, we demonstrate a fully implanted symbiotic pacemaker based on an implantable triboelectric nanogenerator, which achieves energy harvesting and storage as well as cardiac pacing on a large-animal scale. The symbiotic pacemaker successfully corrects sinus arrhythmia and prevents deterioration. The open circuit voltage of an implantable triboelectric nanogenerator reaches up to 65.2 V. The energy harvested from each cardiac motion cycle is 0.495 µJ, which is higher than the required endocardial pacing threshold energy (0.377 µJ). Implantable triboelectric nanogenerators for implantable medical devices offer advantages of excellent output performance, high power density, and good durability, and are expected to find application in fields of treatment and diagnosis as in vivo symbiotic bioelectronics.
Assuntos
Arritmia Sinusal/cirurgia , Fenômenos Eletrofisiológicos , Coração/fisiologia , Nanomedicina/instrumentação , Marca-Passo Artificial , Animais , Arritmia Sinusal/etiologia , Procedimentos Cirúrgicos Cardíacos/instrumentação , Procedimentos Cirúrgicos Cardíacos/métodos , Linhagem Celular , Dimetilpolisiloxanos/química , Modelos Animais de Doenças , Desenho de Equipamento , Masculino , Camundongos , Nanomedicina/métodos , Nylons/química , Politetrafluoretileno/química , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Sus scrofaRESUMO
We describe a case in which reflection of a palatal flap for removal of a mesiodens is presented as the triggering factor for bradycardia caused by stimulation of the trigeminocardiac reflex. The management of the case, as well as the reflex arc, is discussed.