Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2012.07.011
Brazilian Journal of Anesthesiology
Scientific Article

A associação de haloperidol, dexametasona e ondansetrona reduz a intensidade de náusea, dor e consumo de morfina após gastrectomia vertical laparoscópica

Combination of haloperidol, dexamethasone, and ondansetron reduces nausea and pain intensity and morphine consumption after laparoscopic sleeve gastrectomy

Márcio Luiz Benevides; Sérgio de Souza Oliveira; José Eduardo Aguilar-Nascimento

http://dx.doi.org/10.1016/j.bjan.2012.07.011 Braz J Anesthesiol, vol.63, n5, p.404-409, 2013
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Resumo

JUSTIFICATIVA E OBJETIVOS: Náusea e vômito pós-operatório (NVPO) ocorrem frequentemente após cirurgia bariátrica laparoscópica. A associação de haloperidol, dexametasona e ondansetrona pode reduzir esses eventos indesejáveis. O objetivo deste estudo foi avaliar a intensidade de náusea e dor, o número de episódios de vômito e o consumo de morfina no pós-operatório (PO) de pacientes obesos submetidos à gastrectomia vertical laparoscópica (GVL). MÉTODO: Estudo clínico, aleatorizado, controlado e duplamente encoberto feito em 90 pacientes com índice de massa corporal > 35 kg.cm-2. Os pacientes foram distribuídos em três grupos de 30 para receberem no Grupo O: ondansetron 8 mg; no Grupo DO: ondansetron 8 mg e dexametasona 8 mg e no Grupo HDO: ondansetron 8 mg, dexametasona 8 mg e haloperidol 2 mg. Foram avaliados a intensidade de náusea e dor, por meio de escala numérica verbal, o número cumulativo de episódios de vômito e o consumo de morfina no período de 0-2, 2-12, 12-24 e 24-36 horas de PO. RESULTADOS: A intensidade de náusea foi menor no Grupo HDO comparado com o Grupo O (p = 0,001), a intensidade da dor foi menor no Grupo HDO comparado com o Grupo O (p = 0,046) e o consumo de morfina no Grupo HDO foi menor do que no Grupo O (p = 0,037). Não houve diferença do número de episódios de vômito entre os grupos (p = 0,052). CONCLUSÃO: A associação de haloperidol, dexametasona e ondansetron promoveu redução da intensidade de náusea, da dor e do consumo de morfina no PO de pacientes obesos submetidos à GVL.

Palavras-chave

DROGAS, Antiemético, Haloperidol, Ondansetron, Dexametasona, CIRURGIA, Bariátrica, COMPLICAÇÕES, Náusea, Vômito

Abstract

BACKGROUND AND OBJECTIVE: Postoperative nausea and vomiting (PONV) occur frequently after laparoscopic bariatric surgery. The combination of haloperidol, dexamethasone, and ondansetron may reduce these undesirable events. The aim of this study was to evaluate the intensity of nausea and pain, the number of vomiting episodes, and morphine consumption in postoperative (PO) obese patients undergoing laparoscopic sleeve gastrectomy (LSG). METHOD: A clinical, randomized, controlled, double-blind study conducted with 90 patients with body mass index > 35 kg.cm-2. Patients were divided into three groups of 30 individuals to receive ondansetron 8 mg (Group O); ondansetron 8 mg and dexamethasone 8 mg (Group OD); and ondansetron 8 mg, dexamethasone 8 mg, and haloperidol 2 mg (Group HDO). We evaluated the intensity of nausea and pain using the verbal numeric scale, cumulative number of vomiting episodes, and morphine consumption in the period of 0-2, 2-12, 12-24, and 24-36 hours postoperatively. RESULTS: Nausea intensity was lower in Group HDO compared to Group O (p = 0.001), pain intensity was lower in Group HDO compared to Group O (p = 0.046), and morphine consumption was lower in Group HDO compared to Group O (p = 0.037). There was no difference between groups regarding the number of vomiting episodes (p = 0.052). CONCLUSION: The combination of haloperidol, ondansetron, and dexamethasone reduced nausea and pain intensity and morphine consumption in postoperative obese patients undergoing LSG.

Keywords

Antiemetics, Haloperidol, Dexamethasone, Ondansetron, Bariatric Surgery, Postoperative Nausea and Vomiting

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