Papel da lidocaína por via venosa no tratamento da dor na esclerodermia: relato de caso

Durval Campos Kraychete; Ana Cristina Guimarães; Maria Goreth Carvalho; Edgar Marcelino de Carvalho

doi:10.1590/S0034-70942003000600010

Clinical Information

Papel da lidocaína por via venosa no tratamento da dor na esclerodermia: relato de caso

Intravenous lidocaine to treat scleroderma pain: case report

Durval Campos Kraychete; Ana Cristina Guimarães; Maria Goreth Carvalho; Edgar Marcelino de Carvalho

http://dx.doi.org/10.1590/S0034-70942003000600010 Braz J Anesthesiol, vol.53, n6, p.797-801, 2003

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Resumo

JUSTIFICATIVA E OBJETIVOS: A esclerodermia ou esclerose sistêmica progressiva é uma doença sistêmica do tecido conjuntivo, de causa desconhecida, que costuma cursar com microangiopatia, isquemia de extremidades e dor intensa. O objetivo deste relato é descrever um caso do emprego de lidocaína por via venosa no tratamento da dor no curso de isquemia e enfatizar a possível ação antiinflamatória dos anestésicos locais nos pacientes com esclerodermia. RELATO DO CASO: Paciente do sexo feminino, 34 anos, auxiliar de enfermagem, portadora de esclerodermia há aproximadamente 8 anos, apresentava dor de elevada intensidade (escala numérica =10) nos membros superiores e inferiores, contínua, diária, acompanhada de alterações tróficas, da cor e da temperatura e pequenas úlceras nas extremidades. A paciente foi submetida a uma sessão semanal de lidocaína a 2% (400 mg) sem vasoconstritor por via venosa durante 10 semanas com alívio da dor, do turgor, da elasticidade da pele e da perfusão periférica. CONCLUSÕES: O alívio da dor e de outros sintomas após a administração de lidocaína por via venosa sugere que os anestésicos locais podem modular a resposta inflamatória em vários estágios da esclerodermia.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, DOENÇAS, DOR

Abstract

BACKGROUND AND OBJECTIVES: Scleroderma or progressive systemic sclerosis is a systemic connective tissue disease of unknown origin, which normally courses with microangiopathy, extremities ischemia and severe pain. This report aimed at describing a case of intravenous lidocaine to treat ischemic pain and at emphasizing potential anti-inflammatory action of local anesthetics in scleroderma patients. CASE REPORT: Female patient, clear mulatto 34 years old, nursing assistant, with scleroderma for approximately 8 years, presented with severe continuous, daily pain (numeric scale = 10) in upper and lower limbs, followed by trophic, color and temperature changes, and small ulcers on extremities. Patient was submitted to 1 weekly session of intravenous 2% lidocaine (400 mg) without vasoconstrictor for 10 weeks with pain, turgor, skin elasticity and peripheral perfusion improvement. CONCLUSIONS: Pain and other symptoms relief after intravenous lidocaine suggests that local anesthetics are able to modulate inflammatory response in different scleroderma stages.

Keywords

ANESTHETICS, ANESTHETICS, DISEASES, PAIN

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Papel da lidocaína por via venosa no tratamento da dor na esclerodermia: relato de caso

Intravenous lidocaine to treat scleroderma pain: case report

Durval Campos Kraychete; Ana Cristina Guimarães; Maria Goreth Carvalho; Edgar Marcelino de Carvalho

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