Top PDF A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE

A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS  ADJUVANTS TO BUPIVACAINE

A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE

Uncontrolled postoperative pain may produce a range of detrimental acute and chronic effects. Spinal anaesthesia provided by bupivacaine may be too short for providing postoperative analgesia. This study is conducted to evaluate the efficacy of intrathecal fentanyl and intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine with regards to the onset and duration of sensory and motor blockade, as well as postoperative analgesia and adverse effects. Hundred patients aged 18-55 years were randomly divided into two groups, each group consisting of 50 patients of either sex belonging to ASA class I and II posted for elective lower abdominal surgeries were given spinal anaesthesia using bupivacaine 0.5%, heavy 2.5 ml with either fentanyl 25µg (group F) or 5µg of preservative free dexmedetomidine (group D).
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EFFECTS OF PREANESTHETIC SINGLE DOSE INTRAVENOUS DEXMEDETOMIDINE VERSUS  FENTANYL ON HEMODYNAMIC RESPONSE TO ENDOTRACHEAL INTUBATION-A CLINICAL  COMPARATIVE STUDY

EFFECTS OF PREANESTHETIC SINGLE DOSE INTRAVENOUS DEXMEDETOMIDINE VERSUS FENTANYL ON HEMODYNAMIC RESPONSE TO ENDOTRACHEAL INTUBATION-A CLINICAL COMPARATIVE STUDY

There was no statistical difference of the baseline SBP, DBP and MAP of both the study groups. (Table no: 3) Decrease in SBP, DBP and MAP was noted in the Group D, both after infusion of dexmedetomidine and induction of anaesthesia, whereas no such phenomenon was observed in the group F. (Table no: 3) Compared to baseline, although the decrease in SBP, DBP and MAP after infusion of dexmedetomidine was not statistically significant, either in intergroup or intra-group analysis, the change in SBP and MAP reached statistical significance after induction of anaesthesia. (Table no: 3) The increase in SBP peaked at 1 minute after laryngoscopy and intubation, followed by a gradual decline. (Table no: 3) The change of SBP became statistically insignificant (both inter and intra group analysis, compared to baseline) five minutes after laryngoscopy and intubation. (Table no: 3) Till this point of time, SBP in group D was statically significantly lower compared to group F. (Table no: 3) In both the groups, DBP and MAP also peaked at 1 minute after laryngoscopy and
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A CLINICAL STUDY TO EVALUATE THE EFFECTS OF INTRATHECAL DEXMEDETOMIDINE 10 MCG ON  LOW DOSE HYPERBARIC 0.5% BUPIVACAINE (5 MG) FOR SADDLE BLOCK ANAESTHESIA IN ADULT  PATIENTS POSTED FOR ELECTIVE PERIANAL SURGERIES

A CLINICAL STUDY TO EVALUATE THE EFFECTS OF INTRATHECAL DEXMEDETOMIDINE 10 MCG ON LOW DOSE HYPERBARIC 0.5% BUPIVACAINE (5 MG) FOR SADDLE BLOCK ANAESTHESIA IN ADULT PATIENTS POSTED FOR ELECTIVE PERIANAL SURGERIES

Saddle block anaesthesia is most commonly used technique for perineal surgeries, i.e. haemorrhoids, fissure-in-ano, etc., as it is most economical and easy to administer. Low dose local anaesthetics can limit the block level and induce rapid recovery from anaesthesia. The recommended dose for anorectal surgery is 1 –1.5 mL of hyperbaric 0.5% bupivacaine or 5% lidocaine. These patients after perineal surgeries will have severe pain if only local anaesthetics are used, as the duration of action of local anaesthetics will not be prolonged to manage post-operative analgesia. Various adjuvants have been used along with local anaesthetic agents
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COMPARISON OF DEXMEDETOMIDINE, BUPRENORPHINE AND FENTANYL AS AN ADJUVANT TO BUPIVACAINE DURING SPINAL ANAESTHESIA FOR HEMIARTHROPLASTY

COMPARISON OF DEXMEDETOMIDINE, BUPRENORPHINE AND FENTANYL AS AN ADJUVANT TO BUPIVACAINE DURING SPINAL ANAESTHESIA FOR HEMIARTHROPLASTY

Ninety patients of either sex aged between 20-50 years belonging to American Society of Anaesthesiologists (ASA) Class I and II scheduled for hemiarthroplasty surgery under subarachnoid block at P.E.S. Institute of Medical Sciences, Kuppam, were enrolled in this prospective, randomised and double-blinded study. Patients with any contraindication to spinal anaesthesia, ischaemic heart disease, heart blocks, hypertension, renal disorders and severe liver disease, pregnant patients, chronic alcoholics and any drug abusers were excluded from the study. The preferred anaesthesia technique, the Visual Analogue Scale (VAS) for pain and other protocols were explained to the patients preoperatively and informed written consent was taken. In the operating room, an 18G intravenous cannula was inserted on the dorsum of the hand preloaded with 8 mL/kg Ringer’s lactate solution.
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COMPARATIVE STUDY OF HYPERBARIC BUPIVACAINE AND PLAIN  ROPIVACAINE WITH FENTANYL AS AN ADJUVANT FOR SPINAL  ANAESTHESIA IN CEASAREAN SECTION

COMPARATIVE STUDY OF HYPERBARIC BUPIVACAINE AND PLAIN ROPIVACAINE WITH FENTANYL AS AN ADJUVANT FOR SPINAL ANAESTHESIA IN CEASAREAN SECTION

ABSTRACT: Spinal anaesthesia is very popular for cesarean section and currently both hyperbaric and plain solutions of local anaesthesia along with opioids are used. Difference in the baricity can affect the intrathecal distribution of local anaesthetics. AIM: We compared the effects of intrathecal hyperbaric (heavy) 0.5% bupivacaine and isobaric (plain) 0.75%ropivacaine combined with 25micro grams fentanyl regarding the degree of sensory and motor block, quality of intraoperative anaesthesia, side effects and post-operative analgesia in patients undergoing cesarean section by doing a randomized controlled study. MATERIALS AND METHODS: Sixty women undergoing caesarean section were randomized into two groups, Group BF (n=30), group RF (n= 30). Group BF received 10 mg (2 ml) of 0.5% hyperbaric bupivacaine with 25µgs of preservative free fentanyl and Group RF received 15mgs (2ml) 0.75% plain Ropivacaine (isobaric) with 25µgs of fentanyl for spinal anaesthesia. In case of insufficient blocks both the groups were supplemented with analgesic dose of ketamine. RESULTS: No difference was observed in onset time, highest level and recovery of sensory block. Recovery of motor block was slightly prolonged in RF group. The incidence of insufficient block requiring ketamine supplementation and duration of postoperative analgesia was same in both groups. The side effects were also similar in both the groups except for hypotension lower systolic pressure in BF group. The neonatal outcome was unaffected. CONCLUSION: In this study we did not find any difference in the two groups despite difference in density suggesting that the spread of spinal solution is not dependent on density in patients undergoing caesarean section.
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A COMPARATIVE CLINICAL STUDY OF INTRAARTICULAR CLONIDINE V/S DEXMEDETOMIDINE IN  ARTHROSCOPIC KNEE SURGERIES (ACL REPAIR) FOR POSTOPERATIVE ANALGESIA

A COMPARATIVE CLINICAL STUDY OF INTRAARTICULAR CLONIDINE V/S DEXMEDETOMIDINE IN ARTHROSCOPIC KNEE SURGERIES (ACL REPAIR) FOR POSTOPERATIVE ANALGESIA

randomized trial to evaluate the efficacy of intraarticular 0.5%, 20 mL bupivacaine and a compound of bupivacaine with clonidine for postoperative analgesia after arthroscopic knee surgery. They used clonidine in a dose of 1 mcg/kg. They concluded that the compound of intraarticular bupivacaine and clonidine suppresses pain better than intraarticular injection of bupivacaine or use of usual systemic analgesics (p<0.05). In our study we used both clonidine 150 mcg and morphine 2 mg resulted in equivocal analgesia, whereas the combination failed to demonstrate an enhanced analgesic effect. Wanda Joshi et al have demonstrated that the analgesic effect of bupivacaine was enhanced by the addition of IA clonidine. 11 Gentil et al were first investigators to study the
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A COMPARATIVE STUDY OF LEVOBUPIVACAINE WITH CLONIDINE AND LEVOBUPIVACAINE WITH  DEXMEDETOMIDINE IN THORACIC EPIDURAL BLOCK FOR LAPAROSCOPIC CHOLECYSTECTOMY

A COMPARATIVE STUDY OF LEVOBUPIVACAINE WITH CLONIDINE AND LEVOBUPIVACAINE WITH DEXMEDETOMIDINE IN THORACIC EPIDURAL BLOCK FOR LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic cholecystectomy can be easily performed under thoracic epidural block. Adjuvants like clonidine or dexmedetomidine added to levobupivacaine not only produces better quality of block. These drugs minimize hemodynamic changes produced by pneumoperitoneum and also decrease the incidence of shoulder pain. Based on our study, we recommend that dexmedetomidine is a better adjuvant than clonidine when used along with levobupivacaine in thoracic epidural anaesthesia for laparoscopic cholecystectomy.
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COMPARISON OF SINGLE BOLUS DOSE OF DEXMEDETOMIDINE WITH BOLUS PLUS CONTINUOUS INFUSION OF DEXMEDETOMIDINE ON CHARACTERISTIC OF SPINAL ANAESTHESIA WITH HYPERBARIC BUPIVACAINE

COMPARISON OF SINGLE BOLUS DOSE OF DEXMEDETOMIDINE WITH BOLUS PLUS CONTINUOUS INFUSION OF DEXMEDETOMIDINE ON CHARACTERISTIC OF SPINAL ANAESTHESIA WITH HYPERBARIC BUPIVACAINE

In view of above observations, our study concluded that I.V. supplementation of bolus followed by continuous infusion of Inj. Dexmedetomidine prolong the duration of sensory and motor block induced with spinal bupivacaine 0.5% hyperbaric. It provides the stable haemodynamic condition with satisfactory anaesthetic condition with significant decrease in the requirement of intraoperative supplementation of sedative and analgesic drugs. It prolongs the duration of analgesia and decreases early requirement of analgesic drugs and does not increase side effects like hypotension, bradycardia, nausea and vomiting, shivering, pruritus. It also provides satisfactory arousable sedation without causing respiratory depression. So, it is concluded that I.V. bolus plus continuous infusion of Inj. Dexmedetomidine is better alternative to I.V. bolus dexmedetomidine for prolonging sensory block, motor block and duration of analgesia induced with intrathecal hyperbaric bupivacaine.
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Status epilepticus induced by intrathecal bupivacaine use: A case report

Status epilepticus induced by intrathecal bupivacaine use: A case report

Case reports involving the loss of conscious- ness, aphasia and automatism induced by the intrathecal administration of combined spinal an- esthetics that include fentanylbupivacaine or sunfentanyl-bupivacaine have been published. Loss of consciousness and aphasia that developed subsequent to the intrathecal administration of sun- fentanyl-bupivacaine in an article by Franeto and Fisher were found to be associated with opioids [9]. However, a later article by Barbara M. reported of a case where the altered mental state and focal sei- zures with automatism observed subsequent to the administration of fentanyl-bupivacaine could not be stopped in spite of the twice I.V. administration of a total dose of 160 μg naloxone, and thus the altered mental state and focal seizures with automatism were associated with bupivacaine [10]. In another study conducted on two volunteers, complications of the CNS including a transient loss of conscious- ness, muscle twitches, confusion, dysarthria and tinnitus developed after the I.V. infusion of bupiva- caine [11]. These reports show us that bupivacaine may cause epileptic seizures as well as various neurological complications.
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A COMPARATIVE STUDY OF POST OPERATIVE ANALGESIA AFTER  SPINAL NALBUPHINE WITH BUPIVACAINE AND SPINAL  BUPIVACAINE FOR LOWER LIMB SURGERIES

A COMPARATIVE STUDY OF POST OPERATIVE ANALGESIA AFTER SPINAL NALBUPHINE WITH BUPIVACAINE AND SPINAL BUPIVACAINE FOR LOWER LIMB SURGERIES

ABSTRACT: AIM: The purpose of our study was to establish the effectiveness of intrathecal nalbuphine as an adjuvant and also the efficacy of nalbuphine for post-operative analgesia and its side effects if any. MATERIAL AND METHODS: 50 patients of ASA grade I and II, age group of 20-60 years, scheduled for elective lower limb surgeries were chosen for this study, patients were randomised into two equal groups of 25 each, group I (Nalbuphine group) received 3 cc of hyperbaric bupivacaine 0.5%+0.4cc injection nalbuphine (0.4mg) intrathecally, Group II(controlled group) received 3cc of hyperbaric bupivacaine 0.5%+0.4 cc of injection normal saline intrathecally, assessment of motor and sensory blockade was done by bromage scale and pinprick method, pulse rate, B. P, respiratory rate and SPO2 were monitored. RESULTS: The difference was in significant between two groups from onset of sensory and motor blockade but mean time of post-operative analgesia in nalbuphine group –(Group-I)was highly significant than control group (Group-II), no patient developed any side effects in our study. CONCLUSION: Nalbuphine used as an adjuvant to hyperbaric bupivacaine provides better quality of blockade as compared to hyperbaric bupivacaine alone, it also prolongs the post-operative analgesia when used as an adjuvant to spinal bupivacaine in lower limb surgeries
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Rev. Bras. Anestesiol.  vol.63 número2 en v63n2a04

Rev. Bras. Anestesiol. vol.63 número2 en v63n2a04

Results: Baseline values of the TF and HP tests were not statistically different among the groups (6.8 ± 0.15 s). TF and HP latencies in the Control group did not change signifi cantly during the study. TF and HP test results showed that adding 3 and 10 μg dexmedetomidine caused a dose- dependent increase in duration and amplitude of analgesic and nociceptive effect of bupivacaine (TF: 37.52 ± 1.08%, 57.86 ± 1.16% respectively, HP: 44.24 ± 1.15%, 68.43 ± 1.24% respectively). Conclusions: There were no apparent pathohistological changes at least 24 hours after the intrathecal administration of a single dose of dexmedetomidine 3 μg and 10 μg. Dexmedetomidine added to bupivacaine for spinal block improves analgesia and prolongs block duration.
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Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study

Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study

Abstract: Problem statement: The purpose of this study was to evaluate the onset and duration of sensory and motor block as well as operative analgesia and adverse effects of Dex Metedo Midine (DXM) or fentanyl given intrathecally with plain 0.5% bupivacaine for spinal anesthesia. Approach: seventy six patients classified as American Society of Anesthesiologists (ASA) status I, II and III scheduled for vaginal hysterectomy, vaginal wall repair and tension free vaginal tape were prospectively studied. Patients were randomly allocated to receive intrathecally either 10 mg isobaric bupivacaine plus 5 µg dexmetedomidine (group D n = 38) or 10 mg isobaric bupivacaine plus 25 mg fentanyl (group F n = 38), the onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes, and side effects were recorded. Results: Patients in group D had significant longer sensory and motor block times than patients in group F. the mean time of sensory regression to S1 was 274±73 min in group D and 179±47 min in group F (P < 0.001). The regression time of motor block to reach modified Bromage 0 was 240±60 min in group D and 155±46 min in group F (P< 0.001). The onset times to reach T10 dermatome and to reach peak sensory level as well as onset time to reach modified Bromage 3 motor block were not significantly different between the two groups. Conclusion: In women undergoing vaginal reconstructive surgery under spinal analgesia, 10 mg plain bupivacaine supplemented with 5 µg dexmetedomidine produces prolonged motor and sensory block compared with 25 µg fentanyl.
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COMPARISON OF EFFICACY OF BUTORPHANOL AND FENTANYL AS INTRATHECAL ADJUVANT TO BUPIVACAINE

COMPARISON OF EFFICACY OF BUTORPHANOL AND FENTANYL AS INTRATHECAL ADJUVANT TO BUPIVACAINE

ABSTRACT: OBJECTIVE: The objective of the study was to compare the efficacy of butorphanol and Fentanyl as an adjuvant to local anaesthetics in relation to onset, degree and recovery time of sensory and motor blockade in orthopaedic procedures done under spinal anaesthesia. METHODS: In a Randomized double blind study, 90 cases of ASA grade 1 & 2 between the ages of 18-60yrs of either sex undergoing elective lower limb orthopaedic procedures were allocated into three groups of 30 each. Group A received intrathecal 0.5% hyperbaric bupivacaine 3ml with 0.2 ml of normal saline (n=30). Group B received intrathecal 0.5% hyperbaric bupivacaine 3ml with Butorphanol 200microgram. (n=30) Group C received intrathecal 0.5% hyperbaric bupivacaine 3ml with fentanyl 20microgram. (n=30).Vital parameters, onset, level, duration and regression of sensory & motor block, duration of effective analgesia were recorded and compared. Analysis was done by of variance (ANOVA) test. RESULTS: Intrathecal administration of Bupivacaine + Butorphanol (141.6±7.2 min) Bupivacaine+Fentanyl (124.5±7.1min) prolongs 2 segment regression times compared to Bupivacaine with Normal saline (118.3±12.5min) without altering the duration of motor blockade. Duration of effective analgesia was 191.8±19,272.8±17.2 min and 270.0±27.4 min in Group A, Group B and Group C respectively. Post-operative side effects were comparable in all the three groups. CONCLUSION: Both fentanyl and butorphanol given intrathecally along with hyperbaric Bupivacaine prolong the duration of effective analgesia.
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COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE-FENTANYL  AND BUPIVACAINE-SUFENTANIL FOR CAESAREAN SECTION

COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE-FENTANYL AND BUPIVACAINE-SUFENTANIL FOR CAESAREAN SECTION

Highly lipid – soluble synthetic opioids such as Sufentanil and Fentanyl are being increasingly used along with local anaesthetic agents such as Bupivacaine to provide excellent relief of pain unlike hydrophilic opioids (morphine) or intermediate lipid-soluble opioids (Meperidine) which have longer residency time in CSF and associated with cephaled migration. So there is a risk of delayed respiratory depression 12-14 hours after the last dose and they have fairly segmental analgesic profiles.

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A COMPARATIVE STUDY OF INTRATHECAL HYPERBARIC 0.5% BUPIVACAINE VERSUS INTRATHECAL 0.5% ISOBARIC LEVOBUPIVACAINE

A COMPARATIVE STUDY OF INTRATHECAL HYPERBARIC 0.5% BUPIVACAINE VERSUS INTRATHECAL 0.5% ISOBARIC LEVOBUPIVACAINE

due to their three-dimensional structure seem to have less toxic effects on the central nervous system and on the cardiovascular system. However, the reduced toxic potential of the two pure left isomers suggests their use in the clinical situations in which the risk of systemic toxicity related to either overdosing or unintended intravascular injection is high such as during epidural or peripheral nerve blocks. Clinically, levobupivacaine is dosed the same as bupivacaine. So, levobupivacaine, the pure S (-) enantiomer of bupivacaine emerged as a safer alternative for regional anaesthesia than its racemic parent. It demonstrated less affinity and strength of depressant effects onto myocardial and central nervous vital centres in pharmacodynamic studies and a superior pharmacokinetic profile. Clinically, levobupivacaine is well tolerated in a variety of regional anaesthesia techniques both after bolus administration and continuous postoperative infusion. Reports of toxicity with levobupivacaine are scarce and occasional toxic symptoms are usually reversible with minimal treatment with no fatal outcome.
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	Renal Metastasis of a Malignant Myopericytoma: A Case Report and Review of Literature

Renal Metastasis of a Malignant Myopericytoma: A Case Report and Review of Literature

Figure 1: A,B) Computed tomography scan showing a malignant solid renal tumour of the kidney with irregular contrast captation. C) Haematoxylin and eosin staining of the kidney lesion showing a highly cellular tumour (100x). D) Hematoxylin and eosin staining of the original skin lesion showing morphology comparable to the kidney lesion. E) Immunohistochemical expression of CD34 in the original skin lesion. F) Focal immunohistochemical expression of alpha smooth muscle actin in the original skin lesion. G) Negative desmin control with internal positive control of arrector pili muscles in the original skin lesion. H) Negative ETS-related gene control of the original skin lesion with colouring of the tumour vasculature.
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Fields of study and the earnings gap by race in Brazil

Fields of study and the earnings gap by race in Brazil

The detailed questionnaire of the Census provides individual information about education, age, gender, race, employment status, labor earnings and occupation in the main job, and place of residence, among many other variables. Based on the information about race, which is self-reported, the sample is divided into white and black workers, where individuals who reported themselves as black or colored are included in the latter group. Asian and indigenous are excluded. For individuals who completed tertiary education, the Census has information about their fields of study. However, the classification system in 2000 is not the same as that in 2010. The appendix A describes how codes from different Census years are matched in this paper. As also shown in the appendix, the detailed categories for fields of study are aggregated into 10 broader groups, which are used in most of the analysis presented here. The Census questionnaire also allows identifying whether an individual has a graduate degree, although the 2000 survey does not distinguish between master ’s and doctoral degrees. In both periods, fields of study refer to the individuals’ highest degrees.
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Sao Paulo Med. J.  vol.134 número4

Sao Paulo Med. J. vol.134 número4

DESIGN AND SETTING: Randomized study at Ankara Numune Education and Research Hospital, in Turkey. METHODS: Thirty patients presenting American Society of Anesthesiologists physical status I-III were scheduled for elective diagnostic thoracotomy. The patients were randomized to receive either patient- controlled SPA or patient-controlled TEA for post-thoracotomy pain control over a 24-hour period. The two groups received a mixture of 3 µg/ml fentanyl along with 0.05% bupivacaine solution through a patient- controlled analgesia pump. Rescue analgesia was administered intravenously, consisting of 100 mg tramadol in both groups. A visual analogue scale was used to assess pain at rest and during coughing over the course of 24 hours postoperatively.
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A Study of Comparatively Low Achievement Students’ Bilingualized Dictionary Use and their English Learning

A Study of Comparatively Low Achievement Students’ Bilingualized Dictionary Use and their English Learning

Among research into bilingual dictionaries, Knight’s (1994) study showed lower proficiency learners’ improved reading comprehension by using bilingual dictionaries to look up totally unfamiliar words. Other researchers, such as Hulstihn, Hollander and Grenadius (1996), found that learners of all levels can use bilingual dictionaries to learn vocabulary while advanced learners are more likely to use bilingual dictionaries to confirm their understanding of partially known L2 lexical items (Atkins and Varantola 1997; Hulstijn 1993; Knight 1994). In spite of quick consultation of L2 words and L1 equivalents, bilingual dictionaries have attracted criticisms as low level L2 learners might be put under wrong impression that they can find perfect equivalents in both languages. Due to limited information provided in bilingual dictionaries, Hunt (2009) argues that this weakness of bilingual dictionaries may transform language learning into “a matter of one-to-one word translation,” (p.14 ) and in turn students might prefer to employ this strategy to deal with the meanings of unknown words directly. The advantages of quick consultation of L2 words and L1 translations in bilingual dictionaries should be acknowledged as they indeed help learners quickly understand the gist of new words. But, simplistic translations are very likely to blur learners’ view of the correct concept of L2 knowledge and block their progress in developing L2 proficiency level.
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Estudo comparativo entre clonidina associada à bupivacaína e bupivacaína isolada em bloqueio de plexo cervical para endarterectomia de carótida

Estudo comparativo entre clonidina associada à bupivacaína e bupivacaína isolada em bloqueio de plexo cervical para endarterectomia de carótida

Superficial cervical block was done by identifying the external jugular vein and the posterior border of the sternocleido- mastoid muscle. The anesthetic was injected at the junction of those two structures at depth of approximately 3 cm. The need of anesthetic supplementation with 1% lidocaine without vasoconstrictor was assessed when the patient pre- sented pain to the surgical stimulus. Hemodynamic para- meters (heart rate, systolic, mean, and diastolic pressures) were evaluated at 0 (block), 30, 60, 90, and 120 minutes. After the surgery patients were transferred to the recovery room where they remained until they reached an Aldrete- Kroulic index equal or greater than eight.
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