Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942004000400006
Brazilian Journal of Anesthesiology
Scientific Article

Bloqueio peridural sacral: avaliação da duração da analgesia com o uso associado de lidocaína, fentanil e clonidina

Epidural caudal block: evaluation of length of analgesia with the association of lidocaine, fentanyl and clonidine

Carlos Alberto de Souza Martins; Pedro Wanderley de Aragão; João de Oliveira Prazeres; Mahiba Mattar Rahbani de Souza Martins

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Resumo

JUSTIFICATIVA E OBJETIVOS: A associação de diferentes substâncias aos anestésicos locais é feita com o objetivo de melhorar a qualidade do bloqueio e prolongar a duração da analgesia. O objetivo deste trabalho foi comparar a eficácia da associação de clonidina, clonidina e fentanil e do fentanil à lidocaína, no tempo de analgesia pós-operatória. MÉTODO: O estudo envolveu 64 pacientes com idade igual ou superior a 23 anos, estado físico I ou II (ASA), escalados para cirurgia proctológica orificial, submetidos à anestesia peridural sacral. Os pacientes foram distribuídos em 4 grupos de 16: grupo I (lidocaína isolada), grupo II (lidocaína e fentanil), grupo III (lidocaína, fentanil e clonidina) e grupo IV (lidocaína e clonidina). Foram comparadas as características dos bloqueios sensitivo e motor. RESULTADOS: Não houve diferença entre a latência, bem como no nível máximo de bloqueio entre os grupos. A ausência de bloqueio motor foi o resultado mais freqüente, encontrado em cerca de 64% dos pacientes. O intervalo de analgesia foi diferente entre os grupos, sendo mais significativo no grupo III. CONCLUSÕES: O uso da clonidina, associada ou não ao fentanil, prolongou o tempo de analgesia pós-operatória na anestesia peridural sacral com lidocaína.

Palavras-chave

ANALGÉSICOS, ANALGÉSICOS, ANALGESIA PÓS-OPERATÓRIA, ANALGESIA PÓS-OPERATÓRIA, ANALGESIA PÓS-OPERATÓRIA, TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: The association of different substances to local anesthetics aims to improve the blockade quality and prolonging analgesia. The aims of this study were to compare the effectiveness of the association of clonidine, clonidine and fentanyl, and fentanyl, to lidocaine for postoperative analgesia. METHODS: Participated in this study 64 patients aged 23 years or above, physical status ASA I or II, undergoing to orificial proctologic surgery under epidural caudal anesthesia. Patients were distributed in 4 groups of 16: group I (lidocaine alone); group II (lidocaine and fentanyl); group III (lidocaine, fentanyl and clonidine); and group IV (lidocaine and clonidine). The quality of sensory and motor blockade were compared. RESULTS: There has been no difference in onset and maximum block level among groups. Absence of motor block was the most frequent result, found in about 64% of patients. Analgesia length was different among groups, being more significant in group III. CONCLUSIONS: Clonidine, associated or not to fentanyl, has prolonged postoperative analgesia after epidural caudal blockade with lidocaine.

Keywords

ANALGESICS, ANALGESICS, ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES, POSTOPERATIVE ANALGESIA, POSTOPERATIVE ANALGESIA, POSTOPERATIVE ANALGESIA

References

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