RESUMO
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change. We integrated the new evidence into the existing body of medical knowledge and identified practical implications for real world patient care. The articles address issues related to anticoagulation, transfusion threshold, immunosuppressive medications, postoperative delirium, myocardial injury after noncardiac surgery, postoperative pain management, perioperative management of antihypertensives, perioperative fasting, and perioperative diabetic control.
Assuntos
Aminas/normas , Anticoagulantes/normas , Ácidos Cicloexanocarboxílicos/normas , Inibidores de Ciclo-Oxigenase 2/normas , Prática Clínica Baseada em Evidências , Haloperidol/normas , Assistência Perioperatória/normas , Complicações Pós-Operatórias/prevenção & controle , Fator de Necrose Tumoral alfa/normas , Ácido gama-Aminobutírico/normas , Aminas/administração & dosagem , Analgésicos/administração & dosagem , Analgésicos/normas , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Antipsicóticos/normas , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Transfusão de Sangue/normas , Ácidos Cicloexanocarboxílicos/administração & dosagem , Inibidores de Ciclo-Oxigenase 2/administração & dosagem , Delírio/etiologia , Delírio/prevenção & controle , Progressão da Doença , Gabapentina , Haloperidol/administração & dosagem , Haloperidol/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Dor Pós-Operatória/prevenção & controle , Assistência Perioperatória/tendências , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Guias de Prática Clínica como Assunto , Medição de Risco , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Tromboembolia/prevenção & controle , Fator de Necrose Tumoral alfa/administração & dosagem , Fator de Necrose Tumoral alfa/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Ácido gama-Aminobutírico/administração & dosagemRESUMO
A highly selective and sensitive method was developed for simultaneous determination of the antihistaminic drug hydroxyzine (HZ) and its pharmacologically active metabolite cetirizine (CZ) in human serum using haloperidol as internal standard. The method was based on fluorescence labeling of both drugs with a fluorescent arylboronic acid 4-(4,5-diphenyl-1H-imidazol-2-yl)phenyl boronic acid followed by separation on silica column using a mobile phase consisting of acetonitrile and water (90:10, v/v%) containing triethylamine and acetic acid. The labeling reaction conditions were optimized and the liquid-liquid extraction method was successfully applied to extract the both drugs from serum. The linearity range was 0.025-2.00 microg/mL for HZ and CZ. The limit of detection (S/N = 3) was 10 and 5 ng/mL for HZ and CZ, respectively.
