Ruzzon Arthur, Nassif Paulo Afonso Nunes, Prigol Lais, Buzo Lucas, Wendler Guilherme, Wendler Eduardo, Wendler Ilana Barrichello Torres, Ruzzon Igor, Goveia Caio Henrique Marchette, Gonçalves Lucas Augusto Prestes
Postgraduate Program in Principles of Surgery, Mackenzie Evangelical College of Paraná/Medical Research Institute, Curitiba, PR, Brazil.
Rocio Hospital, Campo Largo, PR, Brazil.
Arq Bras Cir Dig. 2021 May 14;34(1):e1530. doi: 10.1590/0102-672020200002e1530.
Nausea and vomiting groups x moments. As the number of bariatric operations increases, there is a greater interest in knowledge, experience and skills in the operative and anesthetic management of obese people. Anesthetic recovery is an important point in the therapeutic approach and less adverse effects delaying discharge of these patients are necessary to be kept in mind by the surgical team.
To compare anesthetic-analgesic techniques in the opioid-sparing era through epidural administration of local anesthetic associated with low-dose morphine vs. clonidine and analyze the impact of analgesia on the effectiveness of postoperative recovery by comparing these two techniques.
Randomized, double-blind clinical trial with 66 patients candidates for Roux-en-Y gastrojejunal bypass divided into two groups: morphine group and clonidine group. Multimodal analgesia included epidural anesthesia with 0.375% ropivacaine 20 ml at the eighth thoracic vertebra with the association of morphine (morphine group) at a dose of 15 mcg / kg or clonidine (clonidine group) at a dose of 1 mcg / kg.
The groups were homogeneous and statistical significance was found when analyzing the difference in pain between them in the first postoperative period. The pain was higher in the clonidine group, as in this period, analgesic rescue was also better in this group. In the other times, there was no significance in the differences regarding pain and rescue. The return of intestinal motility in the morphine group was earlier in the first postoperative period. Nausea, vomiting and hospital discharge did not show significant differences between groups.
Epidural anesthesia with low-dose morphine allowed less pain during the entire hospital stay, with a positive impact on patient recovery.
恶心和呕吐分组x时刻。随着减肥手术数量的增加，人们对肥胖患者手术和麻醉管理方面的知识、经验和技能的关注度越来越高。麻醉恢复是治疗方法中的一个重要环节，手术团队必须牢记减少这些患者出院延迟的不良反应。
在阿片类药物节省时代，通过硬膜外给予低剂量吗啡联合可乐定比较麻醉镇痛技术，并通过比较这两种技术分析镇痛对术后恢复效果的影响。
对66例拟行Roux-en-Y胃空肠旁路手术的患者进行随机双盲临床试验，分为两组：吗啡组和可乐定组。多模式镇痛包括在第八胸椎水平硬膜外注射20 ml 0.375%罗哌卡因，联合吗啡（吗啡组），剂量为15 mcg/kg或可乐定（可乐定组），剂量为1 mcg/kg。
两组具有同质性，在分析术后第一阶段两组之间的疼痛差异时发现有统计学意义。可乐定组疼痛较高，因为在此期间，该组的镇痛补救措施也更好。在其他时间段，疼痛和补救方面的差异无统计学意义。吗啡组术后第一阶段肠道蠕动恢复较早。两组在恶心、呕吐和出院方面无显著差异。
低剂量吗啡硬膜外麻醉在整个住院期间疼痛较轻，对患者恢复有积极影响。
