Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942003000400002
Brazilian Journal of Anesthesiology
Scientific Article

Efeitos da associação entre pequenas doses subaracnóideas de morfina e cetoprofeno venoso e oral em pacientes submetidas à cesariana

Effects of low spinal morphine doses associated to intravenous and oral ketoprofen in patients submitted to cesarean sections

Eliana Marisa Ganem; Norma Sueli Pinheiro Módolo; Fábio Ferrari; Francisco Carlos Obata Cordon; Edgar Shiguero Koguti; Yara Marcondes Machado Castiglia

http://dx.doi.org/10.1590/S0034-70942003000400002 Braz J Anesthesiol, vol.53, n4, p.431-439, 2003
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Resumo

JUSTIFICATIVA E OBJETIVOS: Pequenas doses subaracnóideas de morfina são eficazes em reduzir a dor pós-operatória de pacientes submetidas à cesariana, com menor incidência de efeitos colaterais. O objetivo desta pesquisa foi avaliar a qualidade da analgesia pós-operatória e a ocorrência de efeitos colaterais em pacientes submetidas a cesarianas, sob anestesia subaracnóidea com bupivacaína hiperbárica e morfina nas doses de 0,05 mg e 0,1 mg, associadas ao cetoprofeno pelas vias venosa e oral. MÉTODO: Participaram do estudo 60 gestantes de termo, estado físico ASA I e II, que foram submetidas à cesariana eletiva. As pacientes foram divididas em dois grupos: grupo 1 - morfina 0,1 mg, grupo 2 - 0,05 mg, associada a 15 mg de bupivacaína hiperbárica. Todas receberam cetoprofeno (100 mg) por via venosa no per-operatório e por via oral a cada 8 horas no primeiro dia de pós-operatório. As pacientes foram avaliadas 6, 12 e 24 horas após o término da cirurgia, com relação à intensidade da dor e presença de efeitos colaterais (sedação, prurido, náusea e vômito). A presença destes últimos também foi avaliada no per-operatório. RESULTADOS: Ambos os grupos foram idênticos quanto aos dados antropométricos e à duração da cirurgia e da anestesia. Também foram homogêneos com relação à intensidade da dor pós-operatória e à presença de prurido, sedação, náusea e vômito. CONCLUSÕES: A morfina, nas doses de 0,05 mg e 0,1 mg administradas no espaço subaracnóideo, associada ao cetoprofeno pelas vias venosa e oral, apresentou a mesma qualidade de analgesia pós-operatória e determinou a mesma ocorrência de efeitos colaterais.

Palavras-chave

ANALGÉSICOS, ANALGÉSICOS, ANALGÉSICOS, ANALGÉSICOS, CIRURGIA, CIRURGIA, TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: Low spinal morphine doses are effective in relieving postoperative pain of patients submitted to Cesarean sections, with low incidence of side-effects. This study aimed at evaluating postoperative analgesia and the incidence of side-effects in patients submitted to Cesarean sections under spinal anesthesia with hyperbaric bupivacaine and 0.05 mg and 0.1 mg morphine associated to intravenous and oral ketoprofen. METHODS: Sixty pregnant women, physical status ASA I and II, undergoing elective Cesarean sections, were divided in two groups: group 1 patients were given 0.1 mg spinal morphine, while group 2 received 0.05 mg morphine, both associated to 15 mg hyperbaric bupivacaine. All patients received perioperative 100 mg intravenous ketoprofen and oral ketoprofen at 8-hour intervals in the first postoperative day. Patients were assessed at 6, 12 and 24 hours after surgery for pain intensity and side-effects (sedation, pruritus, nausea and vomiting). Side-effects were also evaluated in the perioperative period. RESULTS: Both groups were similar in demographics and surgery and anesthesia duration. They were also homogeneous in postoperative pain intensity and presence of pruritus, sedation, nausea and vomiting. CONCLUSIONS: Spinal 0.05 mg and 0.1 mg morphine associated to intravenous and oral ketoprofen have provided the same postoperative analgesia and have determined the same incidence of side-effects.

Keywords

ANALGESICS, ANALGESICS, ANALGESICS, ANALGESICS, ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES, SURGERY, SURGERY

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