Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942013000300005
Brazilian Journal of Anesthesiology
Scientific Article

Efeito da administração de solução salina na estabilidade da circulação durante a indução de anestesia geral com propofol em estudo randômico e controlado de procedimentos ginecológicos

Effect of normal saline administration on circulation stability during general anesthesia induction with propofol in gynecological procedures - randomised-controlled study

Daher Rabadi

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Resumo

JUSTIFICATIVA E OBJETIVO: Comparar o efeito da administração profilática de solução salina normal com o efeito hipotensor de propofol em pacientes do sexo feminino programadas para procedimentos ginecológicos. MÉTODO: Foram randomicamente alocadas em dois grupos 69 pacientes, ASA I-II. O Grupo 1 recebeu 5 mL.kg-1 de solução salina a 0,9% 10 minutos antes da indução e o Grupo 2 não recebeu nada (controle). A anestesia foi induzida com propofol e fentanil e depois mantida com propofol e remifentanil. As variáveis hemodinâmicas foram mensuradas pré- e pós-indução da anestesia geral. RESULTADOS: Após a indução, ambos os grupos apresentaram queda significativa da pressão arterial média (p < 0,001) e redução também significativa da frequência cardíaca (p < 0,02 no grupo de estudo e p < 0,001 no grupo de controle). A pressão arterial média pré-indução teve uma queda de mais de 25% em 35% dos pacientes do grupo controle em comparação com apenas 17% dos pacientes que receberam a solução salina (p < 0,04). CONCLUSÃO: A administração profilática de solução salina pode diminuir a porcentagem de pacientes que apresentam queda significativa da pressão arterial após a indução de propofol em anestesia geral.

Palavras-chave

INDUÇÃO ANESTÉSICA, Venosa, HIDRATAÇÃO, Soluções Isotônicas, ANESTESIA, Geral, ANESTÉSICOS, Venoso, propofol, SISTEMA CIRCULATÓRIO

Abstract

BACKGROUND AND OBJECTIVE: To compare the effect of prophylactic administration of normal saline against the hypotensive effect of propofol in female patients booked for gynecological procedures. METHOD: Sixty nine ASA (I, II) patients were randomly allocated into two groups, group 1 received 5 mL.kg-1 of 0.9% normal saline 10 minutes before induction, whereas group 2 received nothing (control). Anesthesia was induced with propofol and fentanyl then maintained with propofol and remifentanil. We measured hemodynamic variables pre and post general anesthesia induction. RESULTS: Both groups had significant drops in post induction mean arterial blood pressure (P < 0.001). Also both groups had significant drops in post induction heart rate ((P < 0.02 in sample group and P < 0.001 in control group), and 35% of patients in the control group had more than 25% drop in the pre induction mean arterial blood pressure, compared with only 17% of patients in the saline group (P < 0.04). CONCLUSION: The prophylactic administration of normal saline could decrease the percentage of patients who had a significant drop in their blood pressure after propofol induction of general anesthesia.

Keywords

Isotonic Solutions, Anesthesia, Propofol, Blood Pressure, Heart Rate

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