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Abstract Introduction Blood is an important resource in several lifesaving interventions, such as anemia correction and improvement of oxygen transport capacity. Despite advances, packed red blood cell (PRBC) transfusion still involves risks. The aim of this study was to describe the knowledge of anesthesiologists about the indications, adverse effects, and alternatives to red blood cell transfusion intraoperatively. Method Cross-sectional study using a questionnaire containing multiple choice questions and clinical cases related to relevant factors on the decision whether to perform PRBC transfusion, its adverse effects, hemoglobin triggers, preventive measures, and blood conservation strategies. The questionnaire was filled without the presence of the investigator. Likert scale was used and the average rank of responses was calculated. The Epi Info 7 software was used for data analysis. Results 79% of the institution's anesthesiologists answered the questionnaire; 100% identified the main adverse effects related to blood transfusion. When asked about the factors that influence the transfusion decision, hemoglobin level had the highest agreement (MR = 4.46) followed by heart disease (MR = 4.26); hematocrit (MR = 4.34); age (RM = 4.1) and microcirculation evaluation (MR = 4.22). Respondents (82.3%) identified levels of Hb = 6 g.dL-1 as a trigger to transfuse healthy patient. Regarding blood conservation strategies, hypervolemic hemodilution (MR = 2.81) and decided by drugs (MR = 2.95) were the least reported. Conclusion We identify a good understanding of anesthesiologists about PRBC transfusion; however, there is a need for refresher courses on the subject.

Resumo Introdução O sangue é importante recurso em diversas intervenções mantenedoras da vida, como corrigir a anemia e melhorar a capacidade de transporte de oxigênio. Apesar dos avanços, a transfusão de concentrado de hemácias (TCH) ainda envolve riscos. O objetivo deste estudo foi descrever o conhecimento dos anestesiologistas sobre as indicações, os efeitos adversos e as opções ao procedimento de transfusão de concentrado de hemácias no intraoperatório. Método Estudo transversal que usou questionário com perguntas de múltipla escolha e casos clínicos, referentes a fatores relevantes na decisão de transfundir concentrado de hemácias, seus efeitos adversos, gatilhos de hemoglobina, suas medidas preventivas e estratégias de conservação de sangue. Respondido sem a presença do pesquisador. Usada a escala de Likert e feito cálculo do ranking médio das respostas. Análise dos dados feita com programa Epi Info 7. Resultados Dos anestesiologistas da instituição, 79% responderam ao questionário e 100% identificaram os principais efeitos adversos relacionados à hemotransfusão. Questionados sobre os fatores que influenciariam na decisão de transfundir, o nível de hemoglobina obteve a maior concordância (RM = 4,46), seguido de cardiopatia (RM = 4,26), níveis de hematócrito (RM = 4,34), idade (RM = 4,1) e avaliação da microcirculação (RM = 4,22). Dos entrevistados, 82,3% identificaram níveis de Hb = 6 g.dL-1 como gatilho para transfundir paciente sadio. Quanto às estratégias de conservação de sangue, a hemodiluição hipervolêmica (RM = 2,81) e a deliberada por medicamentos (RM = 2,95) foram as menos citadas. Conclusão Identificou-se uma boa compreensão dos anestesiologistas a respeito da TCH. No entanto, há necessidade de cursos de atualização sobre o tema.

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Abstract Objective: Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period. The aim of this study was to evaluate the frequency of low back pain during pregnancy and its characteristics. Methods: Cross-sectional study with low-risk pregnant women. After approval by the Human Research Ethics Committee and receiving written informed consent, we included pregnant women over 18 years of age and excluded those with psychiatric disorders, previous lumbar pathologies, and receiving treatment for low back pain. Results: We interviewed 97 pregnant women. The frequency of low back pain was 68%. The mean age was 26.2 years and the median gestational age was 30 weeks. Fifty-eight pregnant women declared themselves as brown (58%). Most (88.6%) were married or living in common-law marriage, 56 (57.7%) worked outside the home, and 71 (73.2%) had completed high school. Low back pain was more frequent during the second trimester of pregnancy (43.9%), referred to as a "burning" sensation in 37.8% of patients, with intermittent frequency in 96.9% of the women. The symptoms got worse at night (71.2%). Resting reduced low back pain in 43.9% of pregnant women, while the standing position for a long time worsened it in 27.2% of patients. Conclusion: Low back pain is common in pregnant women, has specific characteristics, and is more frequent in the second trimester of pregnancy. This indicates the need for prevention strategies that enable better quality of life for pregnant women.

Resumo Objetivo: A lombalgia é uma queixa comum entre grávidas. Estima-se que cerca de 50% das gestantes queixam-se de algum tipo de dor lombar em algum momento da gravidez ou durante o puerpério. O objetivo deste estudo foi avaliar a frequência da lombalgia na gestação e suas características. Método: Estudo de corte transversal com gestantes de baixo risco. Após a aprovação pelo Comitê de Ética em Pesquisa em Seres Humanos e a assinatura do termo de consentimento livre e esclarecido, foram incluídas maiores de 18 anos e alfabetizadas e excluídas gestantes com distúrbios psiquiátricos, com patologias lombares prévias e em tratamento para dor lombar. Resultados: Foram entrevistadas 97 gestantes. A frequência de dor lombar foi 68%. A média de idade foi 26,2 anos e a mediana da idade gestacional de 30 semanas; 58 consideraram-se pardas (58%). A maioria (88,6%) era casada ou vivia em união estável, 56 (57,7%) trabalhavam fora e 71 (73,2%) tinham o ensino médio completo. A lombalgia foi mais frequente durante o segundo trimestre gestacional (43,9%), referida como "em queimação" por 37,8% das pacientes e com frequência intermitente em 96,9%. Os sintomas pioravam no período noturno (71,2%). O repouso reduzia a dor lombar em 43,9%, enquanto a posição ortostática por longo tempo agravava em 27,2%. Conclusão: A lombalgia é comum em gestantes, apresenta características específicas e é mais frequente no segundo trimestre. Isso alerta para a necessidade de serem instituídas estratégias de prevenção que possibilitem melhor qualidade de vida para a gestante.

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INTRODUCTION: Blood is an important resource in several lifesaving interventions, such as anemia correction and improvement of oxygen transport capacity. Despite advances, packed red blood cell (PRBC) transfusion still involves risks. The aim of this study was to describe the knowledge of anesthesiologists about the indications, adverse effects, and alternatives to red blood cell transfusion intraoperatively. METHOD: Cross-sectional study using a questionnaire containing multiple choice questions and clinical cases related to relevant factors on the decision whether to perform PRBC transfusion, its adverse effects, hemoglobin triggers, preventive measures, and blood conservation strategies. The questionnaire was filled without the presence of the investigator. Likert scale was used and the average rank of responses was calculated. The Epi Info 7 software was used for data analysis. RESULTS: 79% of the institution's anesthesiologists answered the questionnaire; 100% identified the main adverse effects related to blood transfusion. When asked about the factors that influence the transfusion decision, hemoglobin level had the highest agreement (MR=4.46) followed by heart disease (MR=4.26); hematocrit (MR=4.34); age (RM=4.1) and microcirculation evaluation (MR=4.22). Respondents (82.3%) identified levels of Hb=6g.dL-1 as a trigger to transfuse healthy patient. Regarding blood conservation strategies, hypervolemic hemodilution (MR=2.81) and decided by drugs (MR=2.95) were the least reported. CONCLUSION: We identify a good understanding of anesthesiologists about PRBC transfusion; however, there is a need for refresher courses on the subject.

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OBJECTIVE: Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period. The aim of this study was to evaluate the frequency of low back pain during pregnancy and its characteristics. METHODS: Cross-sectional study with low-risk pregnant women. After approval by the Human Research Ethics Committee and receiving written informed consent, we included pregnant women over 18 years of age and excluded those with psychiatric disorders, previous lumbar pathologies, and receiving treatment for low back pain. RESULTS: We interviewed 97 pregnant women. The frequency of low back pain was 68%. The mean age was 26.2 years and the median gestational age was 30 weeks. Fifty-eight pregnant women declared themselves as brown (58%). Most (88.6%) were married or living in common-law marriage, fifty-six (57.7%) worked outside the home, and 71 (73.2%) had completed high school. Low back pain was more frequent during the second trimester of pregnancy (43.9%), referred to as a "burning" sensation in 37.8% of patients, with intermittent frequency in 96.9% of the women. The symptoms got worse at night (71.2%). Resting reduced low back pain in 43.9% of pregnant women, while the standing position for a long time worsened it in 27.2% of patients. CONCLUSION: Low back pain is common in pregnant women, has specific characteristics, and is more frequent in the second trimester of pregnancy. This indicates the need for prevention strategies that enable better quality of life for pregnant women.

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JUSTIFICATIVA E OBJETIVOS: O trauma cirúrgico envolvido na colecistectomia videolaparoscópica é sabidamente menor que o do método convencional aberto, entretanto as queixas de dor pós-operatória têm sido relatadas por vários autores. Dentre as técnicas analgésicas a anestesia peridural é eficiente na redução da dor pós-operatória no método convencional, mas raramente é utilizada como método complementar nas colecistectomias por via laparoscópica. O objetivo deste estudo foi avaliar a eficácia da anestesia peridural associada com anestesia geral para controle da dor pós-operatória em pacientes submetidos à colecistectomia videolaparoscópica. MÉTODO: Cinquenta e dois pacientes submetidos à colecistectomia videolaparoscópica foram divididos aleatoriamente em dois grupos. Um grupo recebeu anestesia geral e o outro recebeu anestesia geral associada à anestesia peridural. A avaliação da intensidade da dor foi feita com a escala numérica de dor na sala de recuperação pós-anestésica, nas primeiras 24 horas e após as 48 horas que sucederam a cirurgia. RESULTADOS: Em ambos os grupos a qualidade da analgesia pós-operatória foi similar nos momentos avaliados. O grupo que recebeu anestesia peridural associada à anestesia geral apresentou a vantagem de consumir menos anestésico inalatório, mas com maior ocorrência de retenção urinária. CONCLUSÃO: Os resultados do estudo não evidenciaram razão para a associação da anestesia geral com a peridural em colecistectomia videolaparoscópica, pois a analgesia pós-operatória foi semelhante, porém com mais riscos para o paciente.Descritores: Anestesia peridural, Anti-inflamatório não esteroide, Dor pós-operatória, Colecistectomia videolaparoscópica.

BACKGROUND AND OBJECTIVES: Surgical trauma of videolaparoscopic cholecystectomy is knowingly lower as compared to the conventional open method, however postoperative pain complaints have been reported by several authors. Among analgesic techniques, epidural anesthesia is efficient to decrease postoperative pain of the conventional method, but is seldom used as additional method for laparoscopic cholecystectomies. This study aimed at evaluating the effectiveness of epidural anesthesia associated to general anesthesia to control postoperative pain in patients submitted to videolaparoscopic cholecystectomies. METHOD: Participated in this study 52 patients submitted to videolaparoscopic cholecystectomy, who were randomly distributed in two groups. One group received general anesthesia and the other received general anesthesia associated to epidural anesthesia. Pain intensity was evaluated with the pain numeric scale at the post-anesthetic care unit, in the first 24 and 48 hours after surgery completion. RESULTS: Postoperative analgesia quality was similar for both groups in evaluated moments. The group receiving epidural anesthesia associated to general anesthesia had the advantage of consuming less inhalational anesthetics, but there has been more urinary retention. CONCLUSION: Study results have not evidenced a reason to associate general and epidural anesthesia for videolaparoscopic cholecystectomy because postoperative analgesia was similar, however with higher risks for patients.