Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942005000500002
Brazilian Journal of Anesthesiology
Scientific Article

Efeitos da clonidina por via muscular e perineural no bloqueio do nervo isquiático com ropivacaína a 0,5%

Effects of intramuscular and perineural clonidine on sciatic nerve block with 0.5% ropivacaine

Pablo Escovedo Helayel; Luciano Kroth; Gustavo Luchi Boos; Márcio Tagliari Jahns; Getúlio Rodrigues de Oliveira Filho

http://dx.doi.org/10.1590/S0034-70942005000500002 Braz J Anesthesiol, vol.55, n5, p.483-490, 2005
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Resumo

JUSTIFICATIVA E OBJETIVOS: Foram estudados os efeitos da clonidina sobre a latência, a qualidade da anestesia e a duração da analgesia do bloqueio do nervo isquiático com ropivacaína a 0,5%. MÉTODO: Quarenta pacientes adultos foram submetidos a cirurgias sobre o pé e/ou a face lateral do tornozelo sob bloqueios combinados de nervos femoral e isquiático, por via anterior, em que foram alocados, segundo números aleatórios em grupo 1: 25 mL de ropivacaína a 0,5% e placebo perineural; grupo 2: 2 µg.kg-1 de clonidina por via muscular e 25 mL de ropivacaína a 0,5% perineural; e grupo 3: 2 µg.kg-1 de clonidina e 25 mL de ropivacaína a 0,5% perineural, injetados após obtidas respostas motoras com correntes de 0,2 e 0,5 mA. A sensibilidade e a motricidade foram avaliadas por 30 minutos após o bloqueio. Um escore de efetividade total do bloqueio foi atribuído. A qualidade da anestesia cirúrgica foi classificada com sucesso ou falha, segundo a necessidade de suplementação sistêmica. A duração foi o tempo desde a realização do bloqueio até a primeira solicitação de analgésico. RESULTADOS: As latências medianas foram 5, 12,5 e 17,5 minutos nos grupos 1 a 3, respectivamente (p = 0,11). As taxas de sucesso foram de 100%, 93% e 75%, respectivamente (p = 0,12). A duração da analgesia pós-operatória foi de 14,5, 13,5, e 13,75 horas, respectivamente (p = 0,15). CONCLUSÕES: A clonidina por via muscular ou perineural não influenciou a latência, a qualidade de anestesia ou a duração da analgesia do bloqueio do nervo isquiático com ropivacaína a 0,5%.

Palavras-chave

ANALGÉSICOS, ANESTÉSICOS, ANESTÉSICOS, TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: This study evaluated the effects of clonidine on anesthesia onset, quality and duration of analgesia of sciatic nerve block using 0.5% ropivacaine. METHODS: Forty adult patients scheduled for foot or lateral aspect of the ankle procedures under combined anterior femoral/sciatic nerves block were randomly assigned to group 1, receiving 25 mL of 0.5% ropivacaine plus placebo perineurally, group 2, receiving intramuscular 2 µg.kg-1 clonidine and perineural 25 mL of 0.5% ropivacaine and group 3, receiving perineural 2 µg.kg-1 clonidine and 25 mL of 0.5% ropivacaine injected after motor responses were obtained with stimulations between 0.2 and 0.5 mA. Sensory and motor blocks were assessed for 30 minutes after blockade. A total block effectiveness score was calculated. The quality of surgical anesthesia was classified as success or failure according to the need for systemic intraoperative supplementation. Duration of anesthesia was defined as time from blockade placement until the first analgesic request. RESULTS:Median onset times were 5, 12.5, and 17.5 minutes for groups 1, 2 and 3, respectively (p = 0.11). Success rates were 100%, 93% and 75% (p = 0.12), and postoperative analgesia duration was 14.5, 13.5 and 13.75 hours (p = 0.15) for groups 1, 2 and 3, respectively. CONCLUSIONS:Intramuscular or perineural clonidine has not affected anesthetic onset, quality or the duration of postoperative analgesia of 0.5% ropivacaine-induced sciatic nerve block.

Keywords

ANALGESICS, ANESTHETICS, ANESTHETICS, ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES

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