The addition of clonidine to spinal anesthesia with 0.5% hyperbaric bupivacaine (12.5 mg) and morphine (100 microg) for cesarean section improved the quality of the postoperative analgesia without increasing the incidence of side effects. We suggest that the dose of 15 microg of clonidine should be used.

PURPOSE: To verify the effects of different catecholamines on volemic expansion and on the autonomic nervous system in rabbits that were subjected to hemorrhage. METHODS:Twenty four rabbits subjected to hemorrhage (with a 25% loss of blood volume) and were randomly divided into four experimental groups: 1) HEMO Group underwent replacement with their own blood in an equal volume; 2) SS Group underwent replacement with saline solution (SS) in a volume that corresponded to three times the removed blood volume; 3) ISP Group underwent replacement with SS and isoprenaline; 4) FNL Group underwent replacement with SS and phenylephrine. Spectral Analysis of the heart rate and heart rate variability were performed from the recorded data. Hematocrit was measured throughout the experiment. RESULTS:Replacement with SS and an α-or β-agonist did not produce differences in the intravascular retention compared to replacement with SS alone. An analysis of HRV showed that the FNL group maintained the LF/HF ratio better than ISP and SS. CONCLUSIONS:No difference in vascular retention when α-or β-agonists were added to SS during post-hemorrhagic recovery. The animals in the FNL group maintained the integrity of the autonomic response within normal physiological standards during hemorrhagic stress.

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 -14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 -6.02, p < 0.001). Prior psychiatric illness (OR 3.70 CI95% 2.21 -6.44, p = 0.001), presence of a chronic disease (OR 2.09, CI95% 1.19 -3.83, p = 0.013) and male gender (OR 0.56 CI95% 0.37 -0.86, p = 0.009) were independently associated with stress. Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.