analgesia e sedação da s(+) cetamina e da s(+) cetamina-morfina, associadas à ropivacaína, por via peridural, no pós-operatório de intervenção cirúrgica de abdômen superior analgesia y sedación de la s(+) cetamina y de la s(+) cetamina-morfina, asociadas a la ropivacaína, por vía peridural, en el postoperatorio de intervención quirúrgica de abdomen superior epidural s(+) ketamine and s(+) ketamine-morphine associated with ropivacaine in the postoperative analgesia and sedation of upper abdominal surgery
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Abstract
JUSTIFICATIVA Y OBJETIVOS: La combinación de fármacos, actuando por diferentes mecanismos de acción en el cuerno dorsal de la médula espinal, acarrea una disminución del dolor postoperatorio, con una menor incidencia de los efectos colaterales. El objetivo fue el de evaluar la analgesia y la sedación postoperatorias causadas por la S(+) cetamina y S(+) cetamina-morfina asociadas a la ropivacaína, por vía peridural, en colecistectomía por vía subcostal. MÉTODO: Participaron del estudio 70 pacientes, de ambos sexos, estado físico ASA I y II. Se administraron por vía peridural: ropivacaína a 0,75% asociada al cloruro de sodio a 0,9% en el Grupo Control (GC); ropivacaína a 0,75% asociada a la S(+) cetamina (0,5 mg.kg-1) en el Grupo Cetamina (GK); ropivacaína a 0,75% asociada à S(+) cetamina (0,5 mg.kg-1) y a la morfina (2 mg) en el Grupo Cetamina-Morfina2 (GKM2); ropivacaína a 0,75% asociada a la S(+) cetamina (0,5 mg.kg-1) y a la morfina (3 mg) en el Grupo Cetamina-Morfina3 (GKM3). La analgesia y la sedación fueron observadas a las 2h, 6h y 24h después del término de la operación. RESULTADOS: La sedación fue observada en 2h después de la operación en los grupos GK, GKM2 y GKM3. La analgesia quedó efectiva en el GC en 2h después del postoperatorio, en el GK en la 2h y 6h; en los GKM2 y GKM3 en las 2h, 6h y 24h. CONCLUSIONES: La S(+) cetamina y las asociaciones S(+) cetamina-morfina promovieron sedación hasta 2 horas después del término de la operación. La S(+) cetamina promovió analgesia especialmente 2 en horas y las asociaciones S(+) cetamina-morfina promovieron analgesia principalmente en los momentos de observación de 2h y 6h después del término de la operación.
BACKGROUND AND OBJECTIVES: The association of drugs with different mechanisms of action in the dorsal horn of the spinal cord decreases postoperative pain, with a reduction in the incidence of side effects. The aim of this study was to evaluate postoperative analgesia and sedation by epidural S(+) ketamine and S(+) ketamine-morphine associated with ropivacaine in subcostal cholecystectomy. METHODS: Seventy patients of both genders, physical status ASA I and II, participated in this study. The following drugs were administered epidurally: 0.75% ropivacaine associated with 0.9% sodium chloride in the Control Group (CG); 0.75% ropivacaine associated with S(+) ketamine (0.5 mg.kg-1) in the Ketamine Group (KG); 0.75% ropivacaine associated with S(+) ketamine (0.5 mg.kg-1) and morphine (2 mg) in the Ketamine-Morphine Group2 (KMG2); 0.75% ropivacaine associated with S(+) ketamine (0.5 mg.kg-1) and morphine (3 mg) in the Ketamine-Morphine Group3 (KMG3). Analgesia and sedation were evaluated 2h, 6h, and 24h after the end of the surgery. RESULTS: Sedation was observed up to 2 hours after the end of the procedure in KG, KMG2, and KMG3. Analgesia was effective in CG up to 2 hours after the surgery, at 2h and 6h in KG, and at 2h, 6h, and 24h, in KMG2 and KMG3. CONCLUSIONS: S(+) ketamine and the associations S(+) ketamine-morphine promoted sedation up to 2h after the end of the surgical procedure. S(+) ketamine promoted analgesia especially at the moment of the 2h observation, and the associations of S(+) ketamine-morphine promoted analgesia especially at 2h and 6h after the surgery.
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schnaider2007revistaanalgesia
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| Authors | ;Taylor Brandão Schnaider;Antônio Mauro Vieira;Antônio Carlos Aguiar Brandão;Aretusa Chediak Roquim |
| Journal | methods in molecular biology (clifton, nj) |
| Year | 2007 |
| DOI |
10.1590/S0034-70942007000100002
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