ABSTRACT This study was conducted to evaluate the effect of substituting Tifton 85 hay (Cynodon sp. cv. Tifton 85) with levels of cocoa (Theobroma cacao) byproduct (0, 8, 16, and 24%, diet dry matter basis) in the diet of 16 Holstein × Gir heifers with an average body weight of 363.0±27.7 kg on their nutrient intake, digestibility, and protein balance. The experimental period was 17 days, and the sample collection period was five days. There was no effect of cocoa byproduct on nutrient intake. However, the byproduct affected the digestibility of dry matter, crude protein, neutral detergent fiber, and acid detergent fiber, all of which decreased as the level of inclusion of the byproduct in the diet was increased. Nitrogen balance was negatively affected by the inclusion of 24% cocoa byproduct. It is recommended to use cocoa byproduct up to the level of 16% to replace Tifton 85 grass hay in diets for dairy heifers.

OBJECTIVE: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. CONCLUSION: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

JUSTIFICATIVA E OBJETIVOS: Qualidade em anestesia e na satisfação dos pacientes têm tido acentuado destaque. O objetivo foi avaliar o atendimento anestésico de crianças e adolescentes, entrevistando seus responsáveis. MÉTODO: Foram entrevistados 230 responsáveis por crianças e adolescentes submetidos à anestesia no período compreendido entre abril e dezembro de 2003. Realizou-se entrevista na visita pós-operatória através de questionário com quatro itens: identificação das crianças e de adolescentes e seus responsáveis (item 1); esclarecimentos na visita pré-anestésica (item 2), quanto à anestesia (item 3) e à recuperação pós-anestésica (SRPA) (item 4), determinando-se quem dera as informações aos entrevistados e se houvera complicação no pós-anestésico. O responsável atribuiu nota de 0 a 10 ao Serviço de Anestesiologia. RESULTADOS: A pesquisa foi respondida pela mãe em 189 (82,2%) casos. A maioria dos entrevistados, 114 (75,6%), tinha entre 20 e 39 anos, era casada (148 a 64,3%) e 140 (60,9%) não tinham ocupação. Para 89%, o anestesiologista se identificou; para 37% e 77,4%, esclareceu sobre importância e tempo do jejum; 82%, sobre anemia; 90%, alergia; 46,8%, importância da SRPA; 42,2%, tempo de permanência; 72,9%, estado de saúde de sua criança. Não houve apreensões para 49%, 58% e 58%, respectivamente, no pré, intra e pós-anestésico. Gostariam de ter estado com sua criança/adolescente na chegada à SRPA 78,9%. Foram relacionadas preocupações no período pré, intra e pós-anestésico com o sexo e a idade do paciente - não ter tido nenhuma preocupação - maioria dos entrevistados - e com a escolaridade do entrevistado - quanto mais completa, menor foi o número e a variedade das preocupações relatadas. As notas atribuídas ao Serviço de Anestesiologia tiveram maior freqüência entre 7 e 10 (97,4%). CONCLUSÕES: Considera-se que o Serviço de Anestesiologia desenvolve bom trabalho, apesar de falhas na comunicação, que são de solução simples e dependem mais da vontade do serviço que de seu conhecimento científico.

BACKGROUND AND OBJECTIVES: Anesthetic quality and patients' satisfaction has been increasingly praised. Our objective was to evaluate anesthetic management of children and adolescents in our Hospital, by interviewing parents and/or tutors. METHODS: 230 parents or tutors of children and adolescents submitted to anesthesia in the period April-December 2003 were interviewed during the postoperative visit through a four-item questionnaire: children and adolescents and their parents or tutors identification (item 1); explanations during preanesthetic evaluation (item 2) about anesthesia (item 3) and post-anesthetic recovery (PACU) (item 4). Person informing respondents was identified and the presence of post-anesthetic complications made known. Respondents have scored the Anesthesiology Department from 0 to 10. RESULTS: Survey was answered by mothers in 189 (82.2%) of cases. Most respondents (114, 75.6%) were aged 20 to 39 years, were married (148, 64.3%), and 140 (60.9%) had no job. Anesthesiologists have introduced themselves to 89%; for 37% and 77.4% they have explained the importance and duration the fasting period; 82% were informed about anemia; 90% were informed about allergy; 46.8% were informed about PACU importance; 42.2% were explained about length of stay; 72.9% were informed about the health status of their children. There have been no concerns for 49%, 58% and 58%, respectively about pre, intra and post-anesthetic period; 78.9% would like to have been with their children at PACU arrival. Pre, intra and post-anesthetic concerns were related to patients' age and gender - no concern whatsoever for most respondents - and to respondents' education - the better the education the lower the number and diversity of reported concerns. Scores to the Anesthesiology department were mostly between 7 and 10 (97.4%). CONCLUSIONS: The Anesthesiology Department provides satisfactory services, in spite of communication failures, which are easy to solve and depend more on Department's willingness than on scientific knowledge.

JUSTIFICATIVA Y OBJETIVOS: Calidad en anestesia y satisfacción de los pacientes han tenido acentuado destaque. Nuestro objetivo fue evaluar el servicio anestésico de niños y adolescentes de nuestro Hospital, entrevistando sus responsables. MÉTODO: Fueron entrevistados 230 responsables de niños y adolescentes sometidos a la anestesia en el período comprendido entre abril y diciembre de 2003. Se realizó entrevista en la visita pos-operatoria a través de un cuestionario con cuatro partes: identificación de los niños y adolescentes y sus responsables (parte 1); aclaraciones en la visita pre-anestésica (parte 2), referente a la anestesia (parte 3) y a la recuperación pos-anestésica (SRPA) (parte 4), determinándose quien daría las informaciones a los entrevistados y se hubiese complicación en el pos-anestésico. El responsable atribuyó nota de 0 a 10 al Servicio de Anestesiología. RESULTADOS: La pesquisa fue respondida por la madre en 189 (82,2%) casos. La mayoría de los entrevistados, 114 (75,6%), tenía entre 20 y 39 años, era casada (148 a 64,3%) y 140 (60,9%) no tenían ocupación. Para 89%, anestesiologista se identificó; para 37% y 77,4%, aclaró sobre la importancia y tiempo del ayuno; 82%, sobre anemia; 90%, alergia; 46,8%, importancia de la SRPA; 42,2%, tiempo de permanencia; 72,9%, estado de salud de su niño. No hubo aprehensiones para 49%, 58% y 58%, respectivamente, en el pre, intra y pos-anestésico. Les gustaría haber estado con su niño/adolescente en la llegada a la SRPA, 78,9%. Fueron relacionadas preocupaciones en el período pre, intra y pos-anestésico con el sexo y la edad del paciente - no haber tenido ninguna preocupación - mayoría de los entrevistados - y con la escolaridad del entrevistado - cuanto más completa, menor fue el número y la variedad de las preocupaciones relatadas. Las anotaciones atribuidas al Servicio de Anestesiología tuvieron mayor frecuencia entre 7 y 10 (97,4%). CONCLUSIONES: Se considera que el Servicio de Anestesiología desarrolla un buen trabajo, a pesar de fallos en la comunicación, que son de fácil solución y dependen más de la voluntad del Servicio que de su conocimiento científico.