O bloqueio combinado raqui-peridural com extensão do volume peridural causa nível mais alto de bloqueio do que a raquianestesia com dose única

Canan Salman; Nurten Kayacan; Fatma Ertuğ; rul; Zekiye Bı; gat; Bilge Karslı

doi:10.1590/S0034-70942013000300007

Scientific Article

O bloqueio combinado raqui-peridural com extensão do volume peridural causa nível mais alto de bloqueio do que a raquianestesia com dose única

Combined spinal-epidural anesthesia with epidural volume extension causes a higher level of block than single-shot spinal anesthesia

Canan Salman; Nurten Kayacan; Fatma Ertuğ; rul; Zekiye Bı; gat; Bilge Karslı;

http://dx.doi.org/10.1590/S0034-70942013000300007 Braz J Anesthesiol, vol.63, n3, p.267-272, 2013

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Resumo

JUSTIFICATIVA E OBJETIVOS: Avaliamos os efeitos da administração peridural de levobupivacaína ou solução salina, extensão do volume peridural (EVE), em bloqueio combinado raqui-peridural (BCRP) para cesariana. MÉTODOS: Foram incluídas no estudo 138 pacientes com gravidez a termo de 37-42 semanas programadas para cesariana. O Grupo 1 (n = 48) recebeu raquianestesia com dose única (RADU), o Grupo 2 (n = 45) recebeu BCRP-EVE com solução salina e o Grupo 3 recebeu BCRP-EVE com levobupivacaína. As características do bloqueio motor e sensorial os efeitos nas alterações hemodinâmicas maternas e nos recém-nascidos foram comparados. RESULTADOS: O tempo para atingir o bloqueio sensorial máximo foi significativamente menor no Grupo 3 do que nos grupos 1 e 2 (p < 0,05). O tempo de regressão do bloqueio sensório em dois segmentos foi significativamente menor no Grupo 1, enquanto foi significativamente maior no Grupo 3 em relação ao Grupo 2 (p < 0,05). O tempo de início do bloqueio motor foi significativamente maior no Grupo 1 do que nos grupos 2 e 3 (p < 0,05). O tempo para atingir o bloqueio motor máximo foi significativamente menor no Grupo 3 do que nos grupos 1 e 2 (p < 0,05). O tempo de recuperação do bloqueio motor foi significativamente maior no Grupo 3 do que nos grupos 1 e 2 (p < 0,05). O tempo para o primeiro analgésico foi significativamente maior no Grupo 3 (p < 0,05). CONCLUSÃO: Bloqueio sensório-motor rápido e adequado foi obtido em todas as pacientes do presente estudo; no entanto, o bloqueio sensório-motor teve início mais rapidamente, foi mais prolongado e atingiu um novel mais alto nos grupos 2 e 3; esses efeitos foram mais acentuados no Grupo 3.

Palavras-chave

ANESTÉSICOS, Local, bupivacaína, levobupivacaína, CIRURGIA, Cesárea, Injeções epidurais, TÉCNICAS ANESTÉSICAS, Regional, peridural, subaracnóidea

Abstract

BACKGROUND AND OBJECTIVES: We evaluated the effects of epidural injection with levobupivacaine or serum physiologic, epidural volume extension (EVE), when using combined spinal-epidural anesthesia (CSEA) for cesarean delivery. METHODS: One-hundred and thirty-eight patients with a full-term pregnancy of 37-42 weeks that were scheduled for cesarean delivery were included. Group 1 (n = 48) received single-shot spinal anesthesia (SSS), group 2 (n = 45) received CSEA-EVE with saline, group 3 received CSEA-EVE with levobupivacaine. The characteristics of motor and sensory block, the effects on maternal hemodynamic changes and the effects on the newborn were compared. RESULTS: Time to reach maximum sensory block was significantly shorter in groups 3 than in group 1 and 2 (p < 0.05). Two-segment regression time of sensory block was significantly shorter in group 1, whereas it was significantly longer in group 3 than in group 2 (p < 0.05). Time to onset of motor block was significantly longer in group 1 than in groups 2 and 3 (p < 0.05). Time to reach maximum motor block was significantly shorter in group 3 than in groups 1 and 2 (p < 0.05). Time to recovery of motor block was significantly longer in group 3 than in groups 1 and 2 (p < 0.05). The time to first analgesic was significantly longer in group 3 (p < 0.05). CONCLUSIONS: Sufficient and rapid motor and sensory block was achieved in all the patients in the present study; however, motor and sensory block had faster onset, lasted longer, and was of a higher level in groups 2 and 3; these effects were more pronounced in the group 3.

Keywords

Anesthesia, Spinal, Epidural, Injections, Epidural, Anesthetics, Local, Bupivacaine, Cesarean Section

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O bloqueio combinado raqui-peridural com extensão do volume peridural causa nível mais alto de bloqueio do que a raquianestesia com dose única

Combined spinal-epidural anesthesia with epidural volume extension causes a higher level of block than single-shot spinal anesthesia

Canan Salman; Nurten Kayacan; Fatma Ertuğ; rul; Zekiye Bı; gat; Bilge Karslı;

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