Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942012000600010
Brazilian Journal of Anesthesiology
Special Article

Efeitos da inclinação de agulha peridural e diferentes velocidades de injeção na distribuição de anestesia peridural

Effects of epidural needle rotation and different speeds of injection on the distribution of epidural block

Ozlem Sen; N Ferah Donmez; Dilsen Ornek; Dilek Kalayci; Mahmut Arslan; Bayazit Dikmen

http://dx.doi.org/10.1590/S0034-70942012000600010 Braz J Anesthesiol, vol.62, n6, p.857-862, 2012
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Resumo

JUSTIFICATIVA E OBJETIVOS: Este estudo prospectivo e randomizado avaliou o efeito das velocidades da injeção na anestesia peridural unilateral sobre as características do bloqueio, parâmetros hemodinâmicos e critérios de alta hospitalar em 60 pacientes. Levobupivacaína a 5% foi administrada nos pacientes (n = 30) do Grupo F durante 1 minuto (rápido) e durante 3 minutos nos pacientes (n = 30) do Grupo S (lento), com agulha em ângulo de 5º-10º a partir da linha média. O sucesso da anestesia peridural unilateral foi mais significante no Grupo S do que no Grupo F (70,3% vs 16%, p < 0,001). Nos pacientes do Grupo S, o tempo necessário para o nível máximo de bloqueio sensitivo nos lados não operados foi mais curto e o tempo de regressão para dois segmentos, mais longo (p < 0,05). O tempo para walk-out foi mais longo no Grupo F (p < 0,05). Consideramos que a administração lenta de anestésico local em anestesia peridural unilateral é mais eficaz do que a administração rápida.

Palavras-chave

ANESTÉSICOS, Local, bupivacaína levógira, CIRURGIA, Ortopédica, EQUIPAMENTOS, Cateter peridural, TÉCNICAS ANESTÉSICAS, Regional, peridural

Abstract

BACKGROUND AND OBJECTIVES: This prospective, randomised study examined the effect of injection speeds for unilateral epidural anesthesia on block characteristics, hemodynamic parameters, and discharge criteria in 60 patients. Levobupivacaine 5% was administered to Group F over 1 min (fast) and to Group S over 3 min (slow) (n = 30 each) with the needle angulated at 5º-10º from the midline. Unilateral epidural block was significantly more successful in Group S than in Group F (70.3% vs. 16%; p < 0.001). On the non-operated sides in group S, the maximal sensorial block time was shorter and the regression time for 2 segments was longer (p < 0.05). And the walk-out time was longer in group F (p < 0.05). We consider that the slow administration of local anesthetic in unilateral epidural anesthesia is more effective than rapid administration.

Keywords

Anesthesia, Epidural, Bupivacaine, Catheters, Indwelling, Injections, Epidural, Orthopedic Procedures

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