Desenvolvimento e validacao de versao brasileira do questionario de avaliacao funcional dos membros superiores DASH - disabilities of the Arm, Shoulder and Hand / Development and validation of Brazilian version of the questionnaire for assessing performance of senior members DASH - disabilities of the arm, shoulder and hand

O questionario DASH e uma escala de avaliação funcional dos membros superiores, descrito na lingua inglesa em 1996. Tem hoje vinte e cinco versões ingluindo uma brasileira elaborada na Escola Paulista de Medicina (EPM). (AL)

[Changes in hemodynamics during regional anesthesia and medicinal sedation in children traumatology]. / Izmeneniia gemodinamiki pri primenenii regionarnoi anestezii i medikamentoznoi sedatsii v detskoi travmatologii.

Thirty-nine patients, aged 8 to 15, who were operated for damaged bones in the upper lower limbs were examined. The parameters of central hemodynamics, heart rate and arterial pressure were studied (monitor HP "Viridia m3", USA). Strike volume was determined automatically (rheography monitor NCCOM-3"Boomed Co.", USA). Cardiac output, body area, stroke index and the peripheral vascular resistance were calculated by the routine formulae. Group 1 comprised 20 children who were operated on with the halothane-oxide-oxygen narcosis. Group 2 comprised 19 patients who received regional anesthesia combined with drug sedation (midazolam). A 1% lydokain solution with adrenalin was used as a local anesthetic. The block of the brachial plexus with auxiliary approach and the "3 in 1" block were in use. The changes of hemodynamics detected in the children of group 1 revealed an insufficient analgetic and antistress efficiency of halothane. The data obtained for group 2 are indicative of insignificant hemodynamic changes observed at all examination stages and related with the impact exerted by drugs, used for sedation and regional anesthesia, on the vascular tonus of the original undetected hypovolemia. A lack of complications, a fast awakening and recovery of an adequate consciousness after combined regional anesthesia as well as comfort and a lack of need in extra analgetics that are normally used in the immediate postoperative period make it possible to refer to the discussed anesthesia variation as to the preferential one in cases of surgeries for damaged bones in children.