Profilaxia do prurido causado pela administração subaracnóidea de sufentanil: efeitos do droperidol, da nalbufina, do ondansetron e da combinação deles

André Kolm; Alexandre Alberto Fontana Ferraz; Norma Sueli Pinheiro Módolo; Fábio Ferrari; Eliana Marisa Ganem; Geraldo Rolim Rodrigues Júnior; Paulo do Nascimento Júnior; Giane Nakamura; Lais Helena Camacho Navarro; Rodrigo Moreira Lima

doi:10.1590/S0034-70942006000100004

Scientific Article

Profilaxia do prurido causado pela administração subaracnóidea de sufentanil: efeitos do droperidol, da nalbufina, do ondansetron e da combinação deles

Prevention of itching after spinal sufentanil: effects of droperidol, nalbuphine, ondansetron and the association of them

André Kolm; Alexandre Alberto Fontana Ferraz; Norma Sueli Pinheiro Módolo; Fábio Ferrari; Eliana Marisa Ganem; Geraldo Rolim Rodrigues Júnior; Paulo do Nascimento Júnior; Giane Nakamura; Lais Helena Camacho Navarro; Rodrigo Moreira Lima

http://dx.doi.org/10.1590/S0034-70942006000100004 Braz J Anesthesiol, vol.56, n1, p.28-33, 2006

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JUSTIFICATIVA E OBJETIVOS: O uso espinhal de opióides pode causar alguns efeitos indesejáveis, dentre os quais, o mais freqüente é o prurido que, apesar de sua baixa morbidade, pode proporcionar desconforto intenso ao paciente e prolongar o período de internação. O objetivo deste estudo foi avaliar diversas opções terapêuticas no tratamento profilático do prurido após administração de sufentanil por via subaracnóidea. MÉTODO: Foram distribuídos de maneira aleatória, por sorteio, 100 pacientes a serem submetidos à intervenção cirúrgica não-obstétricas em cinco grupos, de acordo com o tratamento utilizado: controle (ausência de tratamento - C); droperidol 2,5 mg (D); nalbufina 10 mg (N); associação dos medicamentos anteriores (DN) e ondansetron 8 mg (O). O prurido foi avaliado quantitativamente 30 minutos, 1, 2, e 3 horas após a administração subaracnóidea de sufentanil. RESULTADOS: Os grupos C e O apresentaram incidência significativamente maior de prurido em relação aos grupos D, N e DN. Entretanto, não houve diferença significativa na necessidade de tratamento específico com naloxona entre os grupos tratados. CONCLUSÕES: O tratamento profilático do prurido neste estudo, independentemente do fármaco utilizado, diminuiu sua intensidade e limitou a necessidade de tratamento específico com naloxona.

Palavras-chave

ANALGESIA, ANALGÉSICOS, Opióides, ANTAGONISTAS, ANTIEMÉTICOS, ANTIEMÉTICOS, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Spinal opioids may cause some undesirable effects, the most frequent of which is itching. In spite of its low morbidity rate, itching may cause severe discomfort to patients in addition to prolonging hospital stay. This study aimed at evaluating different therapeutic options to prevent itching after spinal sufentanil. METHODS: Participated in these study 100 patients scheduled for non-obstetric procedures, who were randomly distributed in five groups: control (no treatment - C); 2.5 mg droperidol (D); 10 mg nalbuphine (N); association of previous drugs (DN); and 8 mg ondansetron (O). Pruritus was quantitatively evaluated at 30 minutes, 1, 2 and 3 hours after spinal sufentanil. RESULTS: Groups C and O had significantly higher incidence of itching as compared to groups D, N and DN. However, there has been no significant difference in the need for specific treatment with naloxone among groups. CONCLUSIONS: Itching prevention in our study, regardless of the drug used, has decreased its severity and has limited the need for specific treatment with naloxone.

Keywords

ANALGESIA, ANALGESICS, Opioids, ANTAGONISTS, ANTIEMETICS, ANTIEMETICS, COMPLICATIONS

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Profilaxia do prurido causado pela administração subaracnóidea de sufentanil: efeitos do droperidol, da nalbufina, do ondansetron e da combinação deles

Prevention of itching after spinal sufentanil: effects of droperidol, nalbuphine, ondansetron and the association of them

André Kolm; Alexandre Alberto Fontana Ferraz; Norma Sueli Pinheiro Módolo; Fábio Ferrari; Eliana Marisa Ganem; Geraldo Rolim Rodrigues Júnior; Paulo do Nascimento Júnior; Giane Nakamura; Lais Helena Camacho Navarro; Rodrigo Moreira Lima

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