Analgesia regional prolongada com catéteres periféricos: relato de casos

Karl Otto Geier

doi:10.1590/S0034-70942002000100008

Clinical Information

Analgesia regional prolongada com catéteres periféricos: relato de casos

Prolonged regional analgesia with peripheral catheters: case reports

Karl Otto Geier

http://dx.doi.org/10.1590/S0034-70942002000100008 Braz J Anesthesiol, vol.52, n1, p.62-73, 2002

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Resumo

JUSTIFICATIVA E OBJETIVOS: Síndromes de Dor de Manutenção Simpática, Tromboangeíte Obliterante, Esclerodermia Sistêmica Progressiva (doença autoimune) e analgesia pós-operatória respondem muito bem aos anestésicos locais quando em uso prolongado. O objetivo dos casos relatados visa divulgar o uso de catéteres curtos (catéteres venosos) ou segmento de cateter peridural nas situações acima, na falta de material apropriado (Contiplexâ e similares) associados ao estimulador de nervo periférico. RELATO DOS CASOS: São relatados casos de Síndrome de Dor Regional Complexa 1 e 2, úlcera de perna por tromboangeíte obliterante para preparação a enxertia de pele, esclerodermia sistêmica progressiva com comprometimento microcirculatório distal do pé, em que foram colocados catéteres venosos contíguos aos nervos periféricos dos respectivos territórios, visando o controle contínuo da dor através de injeções de anestésicos locais. CONCLUSÕES: Baseados nos princípios que norteiam a boa prática de anestesia regional e nos resultados obtidos, os casos apresentados mostraram que os catéteres usados podem substituir aqueles especialmente designados para as mesmas finalidades.

Palavras-chave

DOR, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: Sympathetic Maintenance Pain Syndrome, Obliterating Thromboangiitis, Progressive Systemic Scleroderma (auto-immune disease) and postoperative analgesia are good responders to prolonged local anesthetics. These reports aimed at spreading the use of short catheters (venous catheters) or epidural catheter segments associated to peripheral nerve stimulator in the above mentioned situations and when adequate material (ContplexÒ and similar equipment) are not available. CASE REPORTS: Cases of Complex Regional Pain 1 and 2, leg ulcer by obliterating thromboangiitis in preparation to skin graft, and progressive systemic scleroderma with distal foot microcirculatory involvement are reported in which venous catheters were inserted close to the peripheral nerves of the respective territories aiming at continuously controlling pain through local anesthetic injections. CONCLUSIONS: Based on regional anesthesia best practices and on the results obtained, all cases reported have shown that investigated catheters may replace those specially designed for the same purposes.

Keywords

ANESTHETIC TECHNIQUES, Regional, PAIN

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Analgesia regional prolongada com catéteres periféricos: relato de casos

Prolonged regional analgesia with peripheral catheters: case reports

Karl Otto Geier

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