Salustiano Gabriel Neto

Marcapasso cardíaco artificial: considerações pré e per-operatórias

BACKGROUND AND OBJECTIVES Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure. This review aimed at familiarizing anesthesiologists with major clinical indications and operation of these devices, as well as with PM-related pre and intraoperative cares. CONTENTS Classification, operation, and major clinical indications for PM implants are covered. In addition, primary PM-related pre and intraoperative cares required for success are explained. CONCLUSIONS Basic understanding of PM operation and indications should be part of anesthesiologists daily practice. Hence, handling and indication of temporary PM broadens these specialists scope, in addition to saving lives in emergency situations. Electric cautery should be avoided in artificial cardiac pacemaker patients.JUSTIFICATIVA Y OBJETIVOS: El progreso tecnologico de la propedeutica medica diagnostica en cardiologia difundio grandemente la indicacion de marcapaso (MP) cardiaco artificial, definitivo o temporario. Esto hizo con que otros especialistas, ademas de los cardiologistas, se envolvieran todavia mas en el manoseo de eses aparatos. Cuando pacientes portadores de MP se presentan para cirugia, la participacion del anestesista puede ser decisiva para el suceso del procedimiento. El objetivo de la actual revision es familiarizar al anestesista con las principales indicaciones clinicas y con el funcionamiento de eses dispositivos, ademas de los cuidados pre y per-operatorios que se debe tener. CONTENIDO: Fueron tratadas la clasificacion, funcionamiento y las principales indicaciones clinicas para la implantacion de MP. De la misma forma, se pretendio elucidar los principales cuidados pre y per-operatorios relativos al uso de MP para lograr exito en el procedimiento indicado. CONCLUSIONES: Los principales conocimientos sobre el funcionamiento del MP y sus indicaciones clinicas deben hacer parte de la practica diaria del anestesista. De esa forma, el manoseo y la indicacion del MP temporario amplia la actuacion de eses especialistas, ademas de que puede salvar vidas, inclusive en situaciones de emergencia dentro del centro quirurgico. El uso de eletrocauterio deberia ser evitado en portadores de MP.

Avaliação da função pulmonar após colecistectomias laparoscópicas e convencionais

BACKGROUND: To evaluate pulmonary function after laparoscopic and subcostal cholecystectomies. METHODS: This was a randomized study, in which postoperative spirometries in two groups of fifteen patients each were evaluated. Group GL underwent laparoscopic chlecystectomies. Group GA underwent open subcostal cholecystectomies by means of mini-laparatomy, in abbreviated anesthetic-surgical time. The two groups´ variables were compared using ANOVA. Within the same group, before and after the operations, the paired Student-t test was used. A value of p < 0.05 was considered statistically significant. RESULTS: All patients from both groups presented restrictive postoperative ventilatory disturbances, with a faster spirometric normalization for those patients operated through laparoscopy. Groups GL vs. GA, in immediate post-operative: Forced Vital Capacity (p < 0.001) and Forced Expiratory Volume in one second (p < 0.001). CONCLUSION: Postoperative harm to pulmonary function was significantly less in laparoscopic than in open cholecystectomies, even with mini-laparotomies and abbreviated anesthetic-surgical time.Background: To evaluate pulmonar y function after lapar oscopic and subcostal cholecystectomies . Methods: This was a randomized study , in which postoperative spir ometries in two gr oups of fifteen patients each wer e evaluated. Gr oup GL underwent lapar oscopic chlecystectomies. Gr oup GA underwent open subcostal cholecystectomies by means of mini-laparatomy , in abbreviated anesthetic-sur gical time. The two gr oups ́ variables wer compar ed using ANOVA. Within the same gr oup, before and after the operations, the paired Student-t test was used. A value of p < 0.05 was considered statistically significant. Results: All patients from both groups presented restrictive postoperative ventilatory disturbances, with a faster spirometric normalization for those patients operated thr ough lapar oscopy. Groups GL vs. GA, in immediate post-operative: For ced Vital Capacity (p < 0.001) and For ced Expirator y Volume in one second (p < 0.001). Conclusion: Postoperative harm to pulmonar y function was significantly less in laparoscopic than in open cholecystectomies, even with mini-laparotomies and abbreviated anesthetic-surgical time.

Influência da morfina peridural na função pulmonar de pacientes submetidos à colecistectomia aberta

BACKGROUND AND OBJECTIVES Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.BACKGROUND AND OBJECTIVES: Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS: In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS: The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS: One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.

The influence of epidural morphine in the pulmonary function of patients undergoing open cholecystectomy

BACKGROUND AND OBJECTIVES Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.BACKGROUND AND OBJECTIVES: Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS: In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS: The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS: One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.

Influencia de la morfina peridural en la función pulmonar de pacientes sometidos a la colecistectomía abierta

BACKGROUND AND OBJECTIVES Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.BACKGROUND AND OBJECTIVES: Upper abdominal surgeries may cause postoperative respiratory dysfunction. The objective of this study was to evaluate the pulmonary function after laparoscopic and open cholecystectomies, with and without epidural morphine. METHODS: In this randomized, double-blind clinical trial, 45 patients undergoing cholecystectomies were divided in three groups: GL, GA, and GAM, composed of 15 patients each. The GL group underwent laparoscopic surgery, while GA and GAM underwent open cholecystectomy, but the former received epidural morphine. Pre- and postoperative spirometry and arterial blood gases were performed. ANOVA was used to verify the hypothesis of equality of the means among the groups. When results were statistically significant, the Tukey test was performed. Paired test t Student was used to verify the hypothesis of equality within a group. A p < 0.05 was considered significant. RESULTS: The pre and immediately postoperative spirometry results were used to determine: a) forced vital capacity (FVC) in GL versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage of the reduction of FVC in GA versus GAM (p = 0.001); b) within each group: in GL, FVC (p = 0.020) and forced expiratory volume in 1 second (FEV1) (p = 0.022); in GA, FVC (p < 0.001) and FEV1 (p < 0.001); and in GAM, FVC (p = 0.007) and FEV1 (p = 0.001). The arterial oxygen pressure (PaO2) was reduced in all three groups. CONCLUSIONS: One can conclude that respiratory dysfunction was less severe in patients operated by laparoscopy and that epidural morphine reversed, partially, the postoperative ventilatory disturbances of open cholecystectomy.

Manoseo peri-operatorio del paciente en uso de amiodarona

BACKGROUND AND OBJECTIVES Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures. CONTENTS The study covers major amiodarone properties, its clinical use, as well as major adverse effects, which may increase patients surgical risk. CONCLUSIONS Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There are reports on severe, treatment - resistant bradycardias as well as on different degrees of atrioventricular block (AVB). Patients should be carefully monitored, especially during major procedures, and vasoactive drugs (isoproterenol) and temporary artificial pacemaker, should be available because they may be critical during the adverse effects treatment.JUSTIFICATIVA Y OBJETIVOS: La amiodarona es un antidisritmico bastante eficaz y indicado en el tratamiento de disritmias ventriculares y supraventriculares, motivo por el cual viene siendo extensamente administrada en la practica clinica. Entretanto, su uso cronico puede estar asociado con serios efectos colaterales, que pueden ser agravados por actos anestesico-cirugicos, aumentando el riesgo de los procedimientos. El presente estudio objetiva revisar los principales efectos de la amiodarona y asociarlos a la practica clinica del anestesista. CONTENIDO: Se trato de las principales propiedades de la amiodarona, su uso clinico, bien como los mas importantes efectos adversos que pueden aumentar el riesgo quirurgico de los pacientes en uso de este antidisritmico. CONCLUSIONES: La amiodarona, a pesar de habitualmente segura y eficiente, puede presentar efectos adversos exacerbados, especialmente para el aparato cardiovascular, durante procedimientos anestesico-cirugicos. Esto se debe posiblemente a las interacciones entre ese farmaco y agentes anestesicos, asociados principalmente a la anestesia general. Hay relatos de bradicardias graves y resistentes a la terapeutica, bien como bloqueo atrioventricular (BAV) en grados variados. El paciente debe ser rigurosamente monitorizado, especialmente en los procedimientos de grande porte, y el anestesista debe estar amparado en el peri-operatorio con drogas vasoactivas (isoproterenol) y marcapaso cardiaco artificial temporario, que pueden ser fundamentales durante el procedimiento.

Peri-operative management of amiodarone patients

BACKGROUND AND OBJECTIVES Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures. CONTENTS The study covers major amiodarone properties, its clinical use, as well as major adverse effects, which may increase patients surgical risk. CONCLUSIONS Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There are reports on severe, treatment - resistant bradycardias as well as on different degrees of atrioventricular block (AVB). Patients should be carefully monitored, especially during major procedures, and vasoactive drugs (isoproterenol) and temporary artificial pacemaker, should be available because they may be critical during the adverse effects treatment.JUSTIFICATIVA Y OBJETIVOS: La amiodarona es un antidisritmico bastante eficaz y indicado en el tratamiento de disritmias ventriculares y supraventriculares, motivo por el cual viene siendo extensamente administrada en la practica clinica. Entretanto, su uso cronico puede estar asociado con serios efectos colaterales, que pueden ser agravados por actos anestesico-cirugicos, aumentando el riesgo de los procedimientos. El presente estudio objetiva revisar los principales efectos de la amiodarona y asociarlos a la practica clinica del anestesista. CONTENIDO: Se trato de las principales propiedades de la amiodarona, su uso clinico, bien como los mas importantes efectos adversos que pueden aumentar el riesgo quirurgico de los pacientes en uso de este antidisritmico. CONCLUSIONES: La amiodarona, a pesar de habitualmente segura y eficiente, puede presentar efectos adversos exacerbados, especialmente para el aparato cardiovascular, durante procedimientos anestesico-cirugicos. Esto se debe posiblemente a las interacciones entre ese farmaco y agentes anestesicos, asociados principalmente a la anestesia general. Hay relatos de bradicardias graves y resistentes a la terapeutica, bien como bloqueo atrioventricular (BAV) en grados variados. El paciente debe ser rigurosamente monitorizado, especialmente en los procedimientos de grande porte, y el anestesista debe estar amparado en el peri-operatorio con drogas vasoactivas (isoproterenol) y marcapaso cardiaco artificial temporario, que pueden ser fundamentales durante el procedimiento.

Manuseio peri-operatório do paciente em uso de amiodarona

BACKGROUND AND OBJECTIVES Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures. CONTENTS The study covers major amiodarone properties, its clinical use, as well as major adverse effects, which may increase patients surgical risk. CONCLUSIONS Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There are reports on severe, treatment - resistant bradycardias as well as on different degrees of atrioventricular block (AVB). Patients should be carefully monitored, especially during major procedures, and vasoactive drugs (isoproterenol) and temporary artificial pacemaker, should be available because they may be critical during the adverse effects treatment.JUSTIFICATIVA Y OBJETIVOS: La amiodarona es un antidisritmico bastante eficaz y indicado en el tratamiento de disritmias ventriculares y supraventriculares, motivo por el cual viene siendo extensamente administrada en la practica clinica. Entretanto, su uso cronico puede estar asociado con serios efectos colaterales, que pueden ser agravados por actos anestesico-cirugicos, aumentando el riesgo de los procedimientos. El presente estudio objetiva revisar los principales efectos de la amiodarona y asociarlos a la practica clinica del anestesista. CONTENIDO: Se trato de las principales propiedades de la amiodarona, su uso clinico, bien como los mas importantes efectos adversos que pueden aumentar el riesgo quirurgico de los pacientes en uso de este antidisritmico. CONCLUSIONES: La amiodarona, a pesar de habitualmente segura y eficiente, puede presentar efectos adversos exacerbados, especialmente para el aparato cardiovascular, durante procedimientos anestesico-cirugicos. Esto se debe posiblemente a las interacciones entre ese farmaco y agentes anestesicos, asociados principalmente a la anestesia general. Hay relatos de bradicardias graves y resistentes a la terapeutica, bien como bloqueo atrioventricular (BAV) en grados variados. El paciente debe ser rigurosamente monitorizado, especialmente en los procedimientos de grande porte, y el anestesista debe estar amparado en el peri-operatorio con drogas vasoactivas (isoproterenol) y marcapaso cardiaco artificial temporario, que pueden ser fundamentales durante el procedimiento.

Artificial cardiac pacemaker: pre and intraoperative considerations

BACKGROUND AND OBJECTIVES Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure. This review aimed at familiarizing anesthesiologists with major clinical indications and operation of these devices, as well as with PM-related pre and intraoperative cares. CONTENTS Classification, operation, and major clinical indications for PM implants are covered. In addition, primary PM-related pre and intraoperative cares required for success are explained. CONCLUSIONS Basic understanding of PM operation and indications should be part of anesthesiologists daily practice. Hence, handling and indication of temporary PM broadens these specialists scope, in addition to saving lives in emergency situations. Electric cautery should be avoided in artificial cardiac pacemaker patients.JUSTIFICATIVA Y OBJETIVOS: El progreso tecnologico de la propedeutica medica diagnostica en cardiologia difundio grandemente la indicacion de marcapaso (MP) cardiaco artificial, definitivo o temporario. Esto hizo con que otros especialistas, ademas de los cardiologistas, se envolvieran todavia mas en el manoseo de eses aparatos. Cuando pacientes portadores de MP se presentan para cirugia, la participacion del anestesista puede ser decisiva para el suceso del procedimiento. El objetivo de la actual revision es familiarizar al anestesista con las principales indicaciones clinicas y con el funcionamiento de eses dispositivos, ademas de los cuidados pre y per-operatorios que se debe tener. CONTENIDO: Fueron tratadas la clasificacion, funcionamiento y las principales indicaciones clinicas para la implantacion de MP. De la misma forma, se pretendio elucidar los principales cuidados pre y per-operatorios relativos al uso de MP para lograr exito en el procedimiento indicado. CONCLUSIONES: Los principales conocimientos sobre el funcionamiento del MP y sus indicaciones clinicas deben hacer parte de la practica diaria del anestesista. De esa forma, el manoseo y la indicacion del MP temporario amplia la actuacion de eses especialistas, ademas de que puede salvar vidas, inclusive en situaciones de emergencia dentro del centro quirurgico. El uso de eletrocauterio deberia ser evitado en portadores de MP.

Marcapaso cardíaco artificial: consideraciones pre y per-operatorias

BACKGROUND AND OBJECTIVES Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure. This review aimed at familiarizing anesthesiologists with major clinical indications and operation of these devices, as well as with PM-related pre and intraoperative cares. CONTENTS Classification, operation, and major clinical indications for PM implants are covered. In addition, primary PM-related pre and intraoperative cares required for success are explained. CONCLUSIONS Basic understanding of PM operation and indications should be part of anesthesiologists daily practice. Hence, handling and indication of temporary PM broadens these specialists scope, in addition to saving lives in emergency situations. Electric cautery should be avoided in artificial cardiac pacemaker patients.JUSTIFICATIVA Y OBJETIVOS: El progreso tecnologico de la propedeutica medica diagnostica en cardiologia difundio grandemente la indicacion de marcapaso (MP) cardiaco artificial, definitivo o temporario. Esto hizo con que otros especialistas, ademas de los cardiologistas, se envolvieran todavia mas en el manoseo de eses aparatos. Cuando pacientes portadores de MP se presentan para cirugia, la participacion del anestesista puede ser decisiva para el suceso del procedimiento. El objetivo de la actual revision es familiarizar al anestesista con las principales indicaciones clinicas y con el funcionamiento de eses dispositivos, ademas de los cuidados pre y per-operatorios que se debe tener. CONTENIDO: Fueron tratadas la clasificacion, funcionamiento y las principales indicaciones clinicas para la implantacion de MP. De la misma forma, se pretendio elucidar los principales cuidados pre y per-operatorios relativos al uso de MP para lograr exito en el procedimiento indicado. CONCLUSIONES: Los principales conocimientos sobre el funcionamiento del MP y sus indicaciones clinicas deben hacer parte de la practica diaria del anestesista. De esa forma, el manoseo y la indicacion del MP temporario amplia la actuacion de eses especialistas, ademas de que puede salvar vidas, inclusive en situaciones de emergencia dentro del centro quirurgico. El uso de eletrocauterio deberia ser evitado en portadores de MP.