Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942002000400002
Brazilian Journal of Anesthesiology
Scientific Article

Eficácia do propofol e da associação de propofol e dexametasona no controle de náusea e vômito no pós-operatório de laparoscopia ginecológica

Efficacy of propofol and propofol plus dexamethasone in controlling postoperative nausea and vomiting of gynecologic laparoscopy

Eliana Marisa Ganem; Fernanda B Fukushima; Daniela S Medeiros da Silva; Giane Nakamura; Yara Marcondes Machado Castiglia; Pedro Thadeu Galvão Vianna

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Resumo

JUSTIFICATIVA E OBJETIVOS: A laparoscopia ginecológica é procedimento que determina alta incidência de náusea e vômito no pós-operatório. Este estudo teve por finalidade comparar a eficácia do propofol isoladamente ou em associação com a dexametasona na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica. MÉTODO: Participaram do estudo 40 pacientes, estado físico ASA I e II, com idades entre 18 e 46 anos, sem queixas gástricas prévias, submetidas à laparoscopia para diagnóstico ou cirurgia. As pacientes foram divididas em 2 grupos: o grupo 1 recebeu (solução fisiológica 2 ml) e o grupo 2 dexametasona (8 mg), por via venosa antes da indução da anestesia. Todas as pacientes receberam midazolam (7,5 mg) por via oral como medicação pré-anestésica, sufentanil (0,5 µg.kg-1), propofol em infusão contínua para indução e manutenção da anestesia (BIS - 60) e N2O/O2 em fração inspirada de O2 a 40% e atracúrio (0,5 mg.kg-1) como bloqueador neuromuscular. A analgesia pós-operatória foi realizada com cetoprofeno (100 mg) e buscopam composto ®.As pacientes fora avaliadas na sala de recuperação pós-anestésica (SRPA) e na enfermaria 1, 2, 3 e 12 horas após a alta da SRPA. RESULTADOS: Ambos os grupos foram idênticos quanto aos dados antropométricos e à duração da cirurgia e da anestesia. No grupo 1 (n = 20) uma paciente apresentou náusea na SRPA e na enfermaria e três pacientes vomitaram na enfermaria. No grupo 2 (n = 20) nenhuma paciente apresentou náusea ou vômito durante o período de observação clínica, resultados estatisticamente não significativos. CONCLUSÕES: O propofol isoladamente ou associado à dexametasona foi eficaz na prevenção de náusea e vômito no pós-operatório de pacientes submetidas à laparoscopia ginecológica

Palavras-chave

CIRURGIA, CIRURGIA, COMPLICAÇÕES, vômito, DROGAS, HIPNÓTICOS

Abstract

BACKGROUND AND OBJECTIVES: Gynecological laparoscopy is a procedure associated to a high incidence of postoperative nausea and vomiting (PONV). This study aimed at comparing the efficacy of propofol or propofol plus dexamethasone in preventing PONV in patients submitted to gynecological laparoscopy. METHODS: Forty female patients, physical status ASA I and II, aged 18 to 46 years, with no previous gastric complaint, undergoing diagnostic or surgical laparoscopy were randomly distri- buted in 2 groups: Group 1 - patients were given 2 ml IV saline solution, while Group 2 was given intravenous dexamethasone (8 mg), before anesthetic induction. All patients were premedicated with oral midazolam (7.5 mg) and induced with sufentanil (0.5 µg.kg-1) and propofol targed controlled infusion (BIS 60), with N2O/O2 (F I O2=0.4) for maintenance. Neuromuscular block was obtained with atracurium (0.5 mg.kg-1). Postoperative analgesia consisted of ketoprofen (100 mg) and butyl-eschopolamine plus dipirone. Patients were evaluated in the PACU and in the ward after 1, 2, 3 and 12 hours after PACU discharge. RESULTS: Both groups were identical regarding demographics data as well as surgery and anesthesia duration. One Group 1 patient referred nausea in postanesthetic care unit and in the ward, and 3 patients referred vomiting in the ward. In Group 2, no patient referred nausea and vomiting, but the difference was not statistically significant. CONCLUSIONS: Propofol or propofol plus dexamethasone were efficient in preventing PONV in patients submitted to gynecological laparoscopy.

Keywords

COMPLICATIONS, DRUGS, HYPNOTICS, SURGERY, SURGERY

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