Papel do anestesista na cirurgia cardiovascular: além do intraoperatório
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Resumo
Objetivo: Realizar uma análise da literatura acerca dos aspectos pré-anestésicos e anestésicos das cirurgias, com enfoque nas cirurgias cardiovasculares. Revisão bibliográfica: As doenças cardiovasculares são a maior causa de morte no Brasil e no mundo e responsáveis por altos gastos em saúde pública no país, promovendo grande quantidade de cirurgias cardiovasculares. A avaliação do risco cirúrgico cardiovascular e o emprego correto dos anestésicos é fundamental para a redução das taxas de mortalidade por diminuir o risco de complicações. O Índice de Risco Cardíaco Revisado (Critério de Lee) é o principal critério utilizado atualmente, baseando-se nas comorbidades pré-existentes e no tipo de cirurgia. Todavia, para cirurgias cardiovasculares, os critérios precisam ser mais específicos, sendo utilizado o EuroSCOREII. Quanto ao emprego dos anestésicos, é necessário escolher aqueles que cumpram com o objetivo da cirurgia e possuam os efeitos adversos menos prejudiciais. Considerações finais: Cabe ao médico anestesiologista, já na consulta pré-operatória, avaliar o paciente e planejar todas as ações necessárias durante a cirurgia cardiovascular e o manejo da dor no pós-operatório. O papel do anestesiologista é essencial para possibilitar a estabilidade necessária ao trabalho do cirurgião cardiovascular, considerando os altos riscos do procedimento.
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