BACKGROUND Fibromyalgia(FM)patients are treated with antidepressants,and in most cases,these drugs lose efficacy or present side effects.Intravenous lidocaine(IL)is an anesthetic drug used in some FM trials.AIM To sys...BACKGROUND Fibromyalgia(FM)patients are treated with antidepressants,and in most cases,these drugs lose efficacy or present side effects.Intravenous lidocaine(IL)is an anesthetic drug used in some FM trials.AIM To systematically review the safety and efficacy of IL in FM patients.METHODS To systematically search PubMed for articles in English,Spanish,and Japanese with English Abstracts on FM and lidocaine between 1966 and February 2021.This study was registered at PROSPERO.RESULTS We found only ten articles published in this field,with a total of 461 patients.Females predominated varying from 95%to 100%in the studies.Age varied from 40.9 to 55 years old.Disease duration varied from 1 mo to 6.4 years.Lidocaine dose varied from 2 to 7.5 mg/kg via intravenous infusion.Follow-up period varied from 65.7 to 90 days.Regarding outcomes,most studies used the visual analogue scale(VAS)for pain;before short-term lidocaine administration,VAS was between 6.1 and 8.1 and after treatment was between 1.7 and 4.5 mm.Concerning long term lidocaine,VAS varied from 30%to 35.4%after lidocaine infusion.Side effects were observed in 0%to 39.6%of cases,they were usually mild or moderate.CONCLUSION This study demonstrates the short-term effectiveness and safety of intravenous lidocaine in FM patients.However,more studies,including long-term follow-up,are still needed.展开更多
Turner-Kieser syndrome is a rare genetic disorder, autosomal dominant, which is related to variable gene expression and high penetrance, due to mutations in the LMX1B gene that affects connective tissue. The clinic ha...Turner-Kieser syndrome is a rare genetic disorder, autosomal dominant, which is related to variable gene expression and high penetrance, due to mutations in the LMX1B gene that affects connective tissue. The clinic has characteristics with alterations in nails, knees, elbows, and presence of iliac horns that makes the anesthetic difficult. However, data in the literature needs more research on this area. The present report is a cesarean section under general intravenous anesthesia performed on a 32-week pregnant woman due to the maternal risk of full-term evolution and aims to contribute to the anesthetic management of patients with this syndrome as there are few descriptions in the literature regarding the anesthetic management in Turner-Kieser syndrome. Even being a case report, the syndrome is rare and it is important to be reported to all anesthesiologists becoming aware of its management and to choose the best technique and anticipate possible complications. During general anesthesia, the technique chosen for the case reported here, we emphasize the risks of possible difficulty in intubating and positioning the patient, as well as renal impairment caused by changes in the cardiovascular autonomic response due to the choice of some drugs. Therefore, in the present report, our option was intravenous general anesthesia because of maternal complications, where fast acting drugs without renal metabolism or excretion were selected, resulting in an uneventful anesthetic procedure.展开更多
文摘BACKGROUND Fibromyalgia(FM)patients are treated with antidepressants,and in most cases,these drugs lose efficacy or present side effects.Intravenous lidocaine(IL)is an anesthetic drug used in some FM trials.AIM To systematically review the safety and efficacy of IL in FM patients.METHODS To systematically search PubMed for articles in English,Spanish,and Japanese with English Abstracts on FM and lidocaine between 1966 and February 2021.This study was registered at PROSPERO.RESULTS We found only ten articles published in this field,with a total of 461 patients.Females predominated varying from 95%to 100%in the studies.Age varied from 40.9 to 55 years old.Disease duration varied from 1 mo to 6.4 years.Lidocaine dose varied from 2 to 7.5 mg/kg via intravenous infusion.Follow-up period varied from 65.7 to 90 days.Regarding outcomes,most studies used the visual analogue scale(VAS)for pain;before short-term lidocaine administration,VAS was between 6.1 and 8.1 and after treatment was between 1.7 and 4.5 mm.Concerning long term lidocaine,VAS varied from 30%to 35.4%after lidocaine infusion.Side effects were observed in 0%to 39.6%of cases,they were usually mild or moderate.CONCLUSION This study demonstrates the short-term effectiveness and safety of intravenous lidocaine in FM patients.However,more studies,including long-term follow-up,are still needed.
文摘Turner-Kieser syndrome is a rare genetic disorder, autosomal dominant, which is related to variable gene expression and high penetrance, due to mutations in the LMX1B gene that affects connective tissue. The clinic has characteristics with alterations in nails, knees, elbows, and presence of iliac horns that makes the anesthetic difficult. However, data in the literature needs more research on this area. The present report is a cesarean section under general intravenous anesthesia performed on a 32-week pregnant woman due to the maternal risk of full-term evolution and aims to contribute to the anesthetic management of patients with this syndrome as there are few descriptions in the literature regarding the anesthetic management in Turner-Kieser syndrome. Even being a case report, the syndrome is rare and it is important to be reported to all anesthesiologists becoming aware of its management and to choose the best technique and anticipate possible complications. During general anesthesia, the technique chosen for the case reported here, we emphasize the risks of possible difficulty in intubating and positioning the patient, as well as renal impairment caused by changes in the cardiovascular autonomic response due to the choice of some drugs. Therefore, in the present report, our option was intravenous general anesthesia because of maternal complications, where fast acting drugs without renal metabolism or excretion were selected, resulting in an uneventful anesthetic procedure.
