Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942006000400004
Brazilian Journal of Anesthesiology
Scientific Article

Atitudes atuais de anestesiologistas e médicos em especialização com relação à anestesia venosa total

Current attitude of anesthesiologists and anesthesiology residents regarding total intravenous anesthesia

Fernando Squeff Nora; Marcos Aguzzoli; Getúlio Rodrigues de Oliveira Filho

http://dx.doi.org/10.1590/S0034-70942006000400004 Braz J Anesthesiol, vol.56, n4, p.362-369, 2006
PDF Português
PDF English
Downloads: 0
Views: 1023

Resumo

JUSTIFICATIVA E OBJETIVOS: No passado, tempo, custos, informações, treinamento e avaliação da profundidade da anestesia limitavam a aceitação da anestesia venosa total (TIVA). O objetivo deste estudo foi determinar atitudes de anestesiologistas e médicos em especialização com relação à anestesia venosa total. MÉTODO: Um questionário foi enviado a 150 anestesiologistas e 102 residentes. A concordância (C) e discordância (D) em cada item foram comparadas por testes z (consenso, se p < 0,05). RESULTADOS: Houve 98 respostas. Os dados representaram números de respostas por categoria. A maioria dos participantes concordou que a qualidade do despertar estimula o uso de TIVA (C/D = 86/8; p < 0,05); que o futuro reside no desenvolvimento de fármacos com rápido início de ação e pronta recuperação (C/D = 88/5; p < 0,05); que gostaria de utilizar TIVA com mais freqüência (C/D = 72/21; p < 0,05) e de saber mais sobre TIVA (C/D = 77/14; p < 0,05). Não houve consenso sobre o nível de conhecimento para realizá-la, comparada com a anestesia inalatória (C/D = 48/47); a maioria não expressou preocupação com a consciência intra-operatória (C/D = 20/77; p < 0,05), mas concordou que a disponibilidade de monitores de consciência aumentaria a utilização de TIVA (C/D = 64/25; p < 0,05). Não houve consenso se a necessidade de bombas de infusão (C/D = 52/40) e custos (C/D = 52/39) limita o seu uso. CONCLUSÕES: As atitudes com relação à TIVA foram predominantemente positivas. Não houve consenso sobre as contribuições do nível de conhecimento, dos dispositivos de infusão e dos custos para o uso de TIVA.

Palavras-chave

METODOLOGIA CIENTÍFICA, TÉCNICAS ANESTÉSICAS, Geral

Abstract

BACKGROUND AND OBJECTIVES: In the past, time, cost, information, training, and the evaluation of the plane of anesthesia limited the acceptance of total intravenous anesthesia (TIVA). The objective of this study was to determine the attitude of anesthesiologists and other anesthesiology residents regarding total intravenous anesthesia. METHODS: A questionnaire was sent to 150 anesthesiologists and 102 residents. The concordance (C) and disaccord (D) of each item were compared by z tests (consensus if p < 0.05). RESULTS: There were 98 responses. The data represent the number of answers for each category. The majority of the participants agreed that the quality of the awakening stimulates the use of the TIVA (C/D = 86/8; p < 0.05); that the future depends on the development of drugs with a fast onset of action and immediate recovery (C/D = 88/5; p < 0.05); that they would like to use TIVA more often (C/D = 72/21; p < 0.05); and to have more information about TIVA (C/D = 77/14; p < 0.05). There was no agreement about the level of knowledge necessary to administer this technique when compared to inhalational anesthesia (C/D = 48/47); the majority of those who answered the questionnaire did not express any concerns with intra-surgical consciousness (C/D = 20/77; p < 0.05) but agreed that de availability of consciousness monitors would increase the use of TIVA (C/D = 64/25; p < 0.05). There was no consensus whether the need for infusion pumps (C/D = 52/40) and costs (CD = 52/39) limit its use. CONCLUSIONS: The attitude regarding TIVA was predominantly positive. There was no consensus on the influence of the level of knowledge, of the infusion pumps, and of the costs on the use of TIVA.

Keywords

ANESTHETIC TECHNIQUES, General, SCIENTIFIC METHODOLOGY

References

Nora FS, Fortis EAF. Influência dos fármacos utilizados na sedação, na indução e manutenção quanto a recuperação da anestesia. Rev Bras Anestesiol. 2000;50:141-148.

Passot S, Servin F, Allary R. Target-controlled versus manually-controlled infusion of propofol for direct laryngoscopy and bronchoscopy. Anesth Analg. 2002;94:1212-1216.

Wright PJ, Dundee JW. Attitudes to intravenous infusion anaesthesia. Anaesthesia. 1982;37:1209-1213.

Hughes MA, Glass PS, Jacobs JR. Context-sensitive half-time in multicompartment pharmacokinetic models for intravenous anesthetic drugs. Anesthesiology. 1992;76:334-341.

Ekman A, Lindholm ML, Lennmarken C. Reduction in the incidence of awareness using BIS monitoring. Acta Anaesthesiol Scand. 2004;48:20-26.

Struys MM, Jensen EW, Smith W. Performance of the ARX-derived auditory evoked potential index as an indicator of anesthetic depth: a comparison with bispectral index and hemodynamic measures during propofol administration. Anesthesiology. 2002;96:803-816.

Nora FS, Aguzzoli M, Fortis EAF. Training in intravenous anaesthesia pre and post course testing improves teaching techniques in future workshops: Annual Scientific Meeting of the UK Society for intravenous anesthesia. 2003.

Oliveira Filho GR. Rotinas de cuidados pós-anestésicos de anestesiologistas brasileiros. Rev Bras Anestesiol. 2003;53:518-534.

Mattar FN. Pesquisa de marketing. 1999.

Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297-334.

Braithwaite D, Emery J, De Lusignan S. Using the Internet to conduct surveys of health professionals: a valid alternative?. Fam Pract. 2003;20:545-551.

Ness TJ, Jones L, Smith H. Use of compounded topical analgesics: results of an Internet survey. Reg Anesth Pain Med. 2002;27:309-312.

Yetter Read C. Conducting a client-focused survey using e-mail. Comput Inform Nurs. 2004;22:83-89.

Kilpatrick GJ, Tilbrook GS. Improved agents for hypnosis and sedation. 2005.

Churnside RJ, Glendenning GA, Thwaites RMA. Resource use in operative surgery: UK general anaesthetic costs in perspective. Br J Med Economics. 1996;10:83-9.

Rowe WL. Economics and anaesthesia. Anaesthesia. 1998;53:782-788.

5dd42ae40e8825b928c63493 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections