Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 118
Rev. bras. cir. cardiovasc ; 35(5): 660-655, Sept.-Oct. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1137323


Abstract Objective: The aim of this study was to evaluate whether sufentanil can reduce emergence delirium in children undergoing transthoracic device closure of ventricular septal defect (VSD) after sevoflurane-based cardiac anesthesia. Methods: From February 2019 to May 2019, 68 children who underwent transthoracic device closure of VSD at our center were retrospectively analyzed. All patients were divided into two groups: 36 patients in group S, who were given sufentanil and sevoflurane-based cardiac anesthesia, and 32 patients in group F, who were given fentanyl and sevoflurane-based cardiac anesthesia. The following clinical data were recorded: age, sex, body weight, operation time, and bispectral index (BIS). After the children were sent to the intensive care unit (ICU), pediatric anesthesia emergence delirium (PAED) and face, legs, activity, cry, consolability (FLACC) scale scores were also assessed. The incidence of adverse reactions, such as nausea, vomiting, drowsiness and dizziness, was recorded. Results: There was no significant difference in age, sex, body weight, operation time or BIS value between the two groups. Extubation time (min), PEAD score and FLACC scale score in group S were significantly better than those in group F (P<0.05). No serious anesthesia or drug-related side effects occurred. Conclusions: Sufentanil can be safely used in sevoflurane-based fast-track cardiac anesthesia for transthoracic device closure of VSD in children. Compared to fentanyl, sufentanil is more effective in reducing postoperative emergence delirium, with lower analgesia scores and greater comfort.

Humans , Male , Female , Child , Anesthetics, Inhalation , Emergence Delirium , Anesthesia, Cardiac Procedures , Heart Septal Defects, Ventricular/surgery , Adjuvants, Anesthesia/therapeutic use , Methyl Ethers , Retrospective Studies , Sufentanil/therapeutic use , Sevoflurane
Rev. cuba. anestesiol. reanim ; 19(1): e546, ene.-abr. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093130


Introducción: El bloqueo terapéutico de ganglio estrellado es un procedimiento para aliviar dolores crónicos de miembros superiores, cabeza y cuello. Actualmente se realiza con anestésicos locales más adyuvantes; pero en Cuba sólo se usan anestésicos locales para este bloqueo. Objetivo: Cotejar información reciente sobre la pertinencia del uso de anestésicos locales con adyuvantes, para estimular la actualización de su práctica nacional acorde a las rutinas y los resultados de esta pericia en el contexto internacional. Métodos: Se revisaron más de 150 informes científicos en línea, referentes a esta técnica a nivel mundial, respecto al uso de drogas y resultados terapéuticos, en bases de datos en inglés, español y portugués. Desarrollo: El bloqueo anestésico precisa conocimientos de farmacología y habilidades prácticas para efectuarlo. La necesidad de anestésicos locales y adyuvantes varía, y depende del paciente y tipo de bloqueo. Para tratar el dolor crónico se usan también opioides, solos y con anestésicos locales. Se publican además beneficios razonables con el uso de ketamina y esteroides en combinación con anestésicos locales. Conclusión: Los resultados terapéuticos más intensos y duraderos que se obtienen al aplicar anestésico local más adyuvante, sugieren actualizar estas prácticas a nivel nacional(AU)

Introduction: The therapeutic block of the stellate ganglion is a procedure for relieving chronic pain of the upper limbs, head, and neck. It is currently performed with more adjuvant local anesthetics, but in Cuba only local anesthetics are used for this block. Objective: To compare recent information about the relevance of using local anesthetics with adjuvants to stimulate the updating of their practice nationally, according to the routines and the outcomes of this expertise in the international setting. Methods: More than 150 scientific reports were reviewed online, referring to this technique worldwide, regarding drug use and therapeutic outcomes, in databases in English, Spanish, and Portuguese. Development: The anesthetic block requires knowledge about pharmacology and practical skills to perform it. The need for local anesthetics and adjuvants varies, and depends on the patient and type of block. Opioids are also used to treat chronic pain, alone or with local anesthetics. Reasonable benefits are also published regarding the use of ketamine and steroids in combination with local anesthetics. Conclusion: The most intense and lasting therapeutic outcomes obtained by applying more adjuvant local anesthetic suggest updating these practices nationally(AU)

Humans , Adjuvants, Anesthesia/therapeutic use , Nerve Block/methods , Stellate Ganglion
Arch. Clin. Psychiatry (Impr.) ; 46(6): 165-168, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054913


Abstract Objective Schizophrenia is a complex and chronic psychiatric disorder. In recent years, studies have found glutamatergic system participation in its etiopathogenesis, especially through aberrant NMDA receptors functioning. Thus, drugs that modulate this activity, as amantadine and memantine, could theoretically be used in its treatment. To perform a systematic literature review about memantine and amantadine use as adjunct in schizophrenia treatment. Methods A systematic review of papers published in English indexed in the electronic database PubMed ® using the terms "memantine", "amantadine" and "schizophrenia" published until October 2016. Results We found 144 studies, 8 selected for analysis due to meet the objectives of this review. Some of these have shown benefits from such drug use, especially in symptoms measured by PANSS and its subdivisions, while others do not. Discussion: The data in the literature about these drugs use for schizophrenia treatment is still limited and have great heterogeneity. Thus, assay with greater robustness are needed to assess real benefits of these drugs as adjuvant therapy.

Humans , Schizophrenia/drug therapy , Amantadine/therapeutic use , Memantine/therapeutic use , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Placebos , Psychiatric Status Rating Scales , Antipsychotic Agents/therapeutic use , Amantadine/adverse effects , Memantine/adverse effects , Double-Blind Method , Treatment Outcome , PubMed , Adjuvants, Anesthesia/therapeutic use
Rev. bras. anestesiol ; 69(4): 369-376, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1042003


Abstract Background and objectives One of the disadvantages of unilateral spinal anesthesia is the short duration of post-operative analgesia, which can be addressed by adding adjuvants to local anesthetics. The aim of current study was to compare the effects of adding dexmedetomidine, fentanyl, or saline to bupivacaine on the properties of unilateral spinal anesthesia in patients undergoing calf surgery. Methods In this double-blind clinical trial, 90 patients who underwent elective calf surgery were randomly divided into three groups. The spinal anesthetic rate in each of the three groups was 1 mL bupivacaine 0.5% (5 mg). In groups BD, BF and BS, 5 µg of dexmedetomidine, 25 µg of fentanyl and 0.5 mL saline were added, respectively. The duration of the motor and sensory blocks in both limbs and the rate of pain during 24 h after surgery were calculated. Hemodynamic changes were also measured during anesthesia for up to 90 min. Results The duration of both of motor and sensory block was significantly longer in dependent limb in the BF (96 and 169 min) and BD (92 and 166 min) groups than the BS (84 and 157 min) group. Visual Analog Scale was significantly lower in the two groups of BF (1.4) and BD (1.3), within 24 h after surgery, than the BS (1.6) group. Conclusions The addition of fentanyl and dexmedetomidine to bupivacaine in unilateral spinal anesthesia can increase the duration of the motor and sensory block in dependent limb and prolong the duration of postoperative pain. However, fentanyl is more effective than dexmedetomidine.

Resumo Justificativa e objetivos Uma das desvantagens da raquianestesia unilateral é a curta duração da analgesia pós-operatória, que pode ser abordada pela adição de adjuvantes aos anestésicos locais. O objetivo deste estudo foi comparar os efeitos da adição de dexmedetomidina, fentanil ou solução salina à bupivacaína sobre as propriedades da raquianestesia unilateral em pacientes submetidos à cirurgia de panturrilha. Métodos Neste ensaio clínico duplo-cego, 90 pacientes submetidos à cirurgia eletiva de panturrilha foram randomicamente divididos em três grupos. A quantidade de anestésico para a raquianestesia nos três grupos foi de 1 mL de bupivacaína a 0,5% (5 mg). Nos grupos BD, BF e BS, 5 µg de dexmedetomidina, 25 µg de fentanil e 0,5 mL de solução salina foram adicionados, respectivamente. Foram calculados a duração dos bloqueios motor e sensorial em ambos os membros e o escore de dor durante 24 horas após a cirurgia. As alterações hemodinâmicas também foram medidas durante a anestesia por até 90 minutos. Resultados A duração de ambos os bloqueios, motor e sensorial, foi significativamente maior no membro dependente nos grupos BF (96 e 169 min) e BD (92 e 166 min) do que no grupo BS (84 e 157 min). Os escores da escala visual analógica foram significativamente menores nos grupos BF (1,4) e BD (1,3) do que no grupo BS (1,6) nas 24 horas após a cirurgia. Conclusões A adição de fentanil e dexmedetomidina à bupivacaína em raquianestesia unilateral pode aumentar a duração dos bloqueios sensorial e motor no membro dependente e prolongar a duração da dor pós-operatória. Contudo, fentanil é mais eficaz do que dexmedetomidina.

Humans , Male , Female , Adult , Young Adult , Bupivacaine/administration & dosage , Fentanyl/administration & dosage , Dexmedetomidine/administration & dosage , Anesthesia, Spinal/methods , Pain, Postoperative/prevention & control , Double-Blind Method , Lower Extremity/surgery , Adjuvants, Anesthesia/administration & dosage , Anesthetics, Local/administration & dosage , Middle Aged
Pesqui. vet. bras ; 39(3): 214-220, Mar. 2019. tab, ilus
Article in English | ID: biblio-1002798


The objective of this study was to evaluate the quality and recovery from anesthesia promoted by the tiletamine-zolazepam (TZ) combination administered intravenously (IV) continuously in bitches pre-medicated with acepromazine. Eight cross-bred, clinically healthy bitches weighing 13.7 ±1.9kg on average were used in this study. After a food fast of 12 h and a water fast of four hours, the animals were treated with acepromazine (0.1mg/kg, intramuscular) and, after 15 minutes, anesthesia was induced with a combination of tiletamine-zolazepam (2mg/kg, IV) immediately followed by continuous IV infusion thereof at a dose of 2mg/kg/h for 60 min. The following parameters were measured in all animals immediately before administration of acepromazine (M15), immediately before anesthetic induction (M0), and at 5, 10, 20, 30, 40, 50, and 60 min after initiation of continuous infusion (M5, M10, M20, M30, M40, M50, and M60): electrocardiography (ECG), heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), body temperature (BT), and arterial hemogasometry, with the last performed only at experimental times M15, M0, M30, and M60. A subcutaneous electrical stimulator was used to evaluate the degree of analgesia. Myorelaxation and quality of anesthetic recovery were also assessed, classifying these parameters as excellent, good, and poor. Anesthetic recovery time was recorded in minutes. HR increased significantly at time M10 in relation to that at M-15, and at times M5, M10, M40, and M50 in relation to that at M0. MAP decreased significantly at M20 and M30 compared with the baseline. BT decreased significantly at M50 compared with that at M0, but no hypothermia was observed. RR showed significant reduction at M5, M10, and M20 in relation to that at M-15, and at M5 and M10 in relation to that at M0, and bradypnoea was observed during the first 20 min after anesthetic induction. Significant decreases in the PR interval at times M10, M40, and M50 were observed in relation to that at M15. Amplitude of the R wave showed significant decrease at M20 compared with that at M-15. In the other ECG parameters, no significant difference was observed between the times evaluated. Hemogasometric parameters and analgesia did not show significant alterations. Myorelaxation and quality of anesthetic recovery were considered excellent. Recovery time was 15.1±7.7 min for positioning of sternal decubitus and 45.5±23.1 minutes for return of ambulation. Continuous IV administration of TZ combination does not produce satisfactory analgesia and does not cause severe cardiorespiratory and hemogasometric effects in bitches pre-medicated with acepromazine.(AU)

Objetivou-se avaliar a qualidade e a recuperação da anestesia promovida pela associação tiletamina-zolazepam, administrada por via intravenosa (IV) contínua, em cadelas pré-medicadas com acepromazina. Foram utilizadas oito cadelas, sem raças definidas, clinicamente sadias, pesando em média 13,7±1,9kg. Após jejum alimentar de 12 horas e hídrico de quatro horas, os animais foram medicados com acepromazina (0,1mg/kg, via intramuscular) e, após 15 minutos, a anestesia foi induzida com a associação tiletamina-zolazepam (2mg/kg, IV) seguida imediatamente pela infusão IV contínua da mesma, na dose de 2mg/kg/h, durante 60 minutos. Os parâmetros que foram mensurados em todos os animais, imediatamente antes da administração da acepromazina (M-15), imediatamente antes da indução anestésica (M0) e, aos 5, 10, 20, 30, 40, 50 e 60 minutos após o início da infusão contínua (M5, M10, M20, M30, M40, M50 e M60) foram os seguintes: eletrocardiografia (ECG), frequência cardíaca (FC), pressão arterial média (PAM), frequência respiratória (f), temperatura corpórea (TC) e hemogasometria arterial, esta sendo realizada apenas nos momentos M-15, M0, M30 e M60. Para avaliação do grau de analgesia foi empregado um estimulador elétrico subcutâneo. Também se avaliou o miorrelaxamento e a qualidade da recuperação anestésica, classificando estes parâmetros em: excelente, bom e ruim. O tempo de recuperação anestésica foi registrado em minutos. A FC aumentou significativamente no momento M10 em relação ao M-15, e nos momentos M5, M10, M40 e M50 em relação ao M0. A PAM diminuiu significativamente em M20 e M30 em comparação ao valor basal. A TC diminuiu significativamente em M50 em comparação ao M0, mas não foi observada hipotermia. A f apresentou uma redução significativa nos momentos M5, M10 e M20 em relação ao M-15, e em M5 e M10 em relação ao M0, sendo observado bradipneia durante os primeiros 20 minutos após a indução anestésica. Foram observadas diminuições significativas do intervalo PR nos momentos M10, M40 e M50, em relação ao M-15. A amplitude da onda R apresentou diminuição significativa em M20 em comparação ao M-15. Nos demais parâmetros da ECG não houve diferença significativa entre os momentos avaliados. Os parâmetros hemogasométricos e a analgesia não apresentaram alterações significativas. O miorrelaxamento e a qualidade da recuperação anestésica foram considerados excelentes. O período de recuperação foi de 15,1±7,7 minutos para posicionamento do decúbito esternal e 45,5±23,1 minutos para retorno da deambulação. A administração intravenosa contínua de tiletamina-zolazepam não produz analgesia satisfatória e não causa efeitos cardiorrespiratórios e hemogasométricos severos, em cadelas pré-tratadas com acepromazina.(AU)

Animals , Female , Dogs , Tiletamine/pharmacology , Zolazepam/pharmacology , Anesthesia Recovery Period , Respiratory Rate/drug effects , Heart Rate/drug effects , Adjuvants, Anesthesia , Anesthesia, Intravenous/veterinary , Acepromazine/pharmacology
Dolor ; 28(70): 30-34, dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-1117989


La anestesia regional pediátrica, ya sea los bloqueos neuroaxiales como periféricos, constituye actualmente un pilar fundamental en el manejo analgésico multimodal orientado a los periodos intra y postoperatorio; facilitando una recuperación postquirúrgica óptima y un alta precoz en niños. La inyección única de anestésicos locales en el bloqueo regional posee una duración limitada. Para conocer las técnicas y fármacos coadyuvantes de los anestésicos locales disponibles, destinados a prolongar la duración del bloqueo en inyección única, hemos efectuado una revisión del uso de fármacos coadyuvantes de los anestésicos locales utilizados, describiendo los mecanismos de acción, la evidencia clínica de sus beneficios; como también, la incidencia de complicaciones y los riesgos asociados a su uso.

Pediatric regional anesthesia, whether neuro axial or peripheral nerve blocks, is currently a base in multimodal analgesic management aimed at the intra and postoperative periods; enabling optimal postoperative recovery and early discharge in children. Single injection of local anesthetics in regional blockade has a limited duration. In order to know the techniques and adjuvant drugs of the available local anesthetics, designed to prolong the duration of block in single injection, we have reviewed the use of adjuvants, describing the mechanisms of action, the clinical evidence of their benefits; as well as, the incidence of complications and the risks associated with its use.

Humans , Child , Pain, Postoperative/prevention & control , Pain Management/methods , Adjuvants, Anesthesia/administration & dosage , Anesthesia, Conduction/methods
Egyptian Journal of Hospital Medicine [The]. 2018; 71 (3): 2836-2844
in English | IMEMR | ID: emr-192537


Background: intravenous regional anesthesia [IVRA] was first described almost a century ago by August Bier and has been used for the past 50 years. It is a safe anesthetic technique for upper or lower distal limb surgery

Purpose: to compare the onset time of sensory blockade when adding ketorolac versus adding magnesium to the IVRA solution, and to compare the duration of postoperative analgesia

Material and Methods: this is a randomized controlled trial in two groups. The study was performed in Ain Shams University Hospitals. Study period range was 1-2 years

Results: there are 146 patients participated in our study, patients were allocated to two groups 73 patients in each group, a group of which received magnesium sulphate solution and the other received ketorolac solution

Conclusion: we evaluated the effects of adding ketorolac and compared it to the effects of adding magnesium sulphate to the anesthetic solution used in IVRA and we found that magnesium sulphate addition can be of benefit in faster onset of sensory block in the operative limb. However, magnesium sulphate in the used concentration [10 ml MgSo4 10% in 40 ml solution] appeared to cause burning pain varying in intensity while injecting the anesthetic solution

Humans , Adolescent , Adult , Middle Aged , Ketorolac , Magnesium Sulfate , Adjuvants, Anesthesia , Lidocaine , Anesthesia, Intravenous , Upper Extremity/surgery , Analgesia , Postoperative Period
Article in English | AIM | ID: biblio-1272238


Background: This randomised, double-blind study was designed to assess the analgesic efficacy of dexmedetomidine as compared with fentanyl as an adjunct to local anaesthetic in thoracic epidural for upper abdominal surgeries. Methods: Forty adult patients of American Society of Anesthesiologists grade I­II undergoing upper abdominal surgery were randomly allocated into two groups to receive 50 µg fentanyl or 50 µg dexmedetomidine as an adjunct to 10 ml 0.125% bupivacaine via thoracic epidural. Anaesthesia was induced with morphine, propofol and vecuronium and maintained by isoflurane with 60% nitrous oxide in oxygen. In the postoperative period patient-controlled analgesic pumps were used to deliver similar types of mixtures via the epidural catheter. Patients were evaluated for rescue analgesic requirements, haemodynamic stability, postoperative pain, sedation and any adverse events. Results: The groups were comparable regarding intraoperative analgesic requirements, recovery times and postoperative pain scores. The total consumption of rescue analgesia was significantly less in the dexmedetomidine group as compared with the fentanyl group (p = 0.049). Two patients in the fentanyl group had vomiting and one had pruritus. None of the patients had bradycardia, hypotension, excessive sedation or respiratory depression. Patients receiving epidural dexmedetomidine were more satisfied with the technique than those receiving fentanyl (p < 0.001). Conclusion: It was concluded that the addition of dexmedetomidine with 0.125% bupivacaine in thoracic epidural provides effective perioperative analgesia with greater patient satisfaction compared with fentanyl

Adjuvants, Anesthesia , Analgesics , Dexmedetomidine , Fentanyl , Pain, Postoperative , Patients
Article in English | WPRIM | ID: wpr-742179


BACKGROUND: Magnesium is one of the effective, safe local anesthetic adjuvants that can exert an analgesic effect in conditions presenting acute and chronic post-sternotomy pain. We studied the efficacy of continuous infusion of presternal magnesium sulfate with bupivacaine for pain relief following cardiac surgery. METHODS: Ninety adult patients undergoing valve replacement cardiac surgery randomly allocated into three groups. In all patients; a presternal catheter was placed for continuous infusion of either 0.125% bupivacaine and 5% magnesium sulfate (3 ml/h for 48 hours) in group 1, or 0.125% bupivacaine only in the same rate in group 2, versus conventional intravenous paracetamol and ketorolac in group 3. Rescue analgesia was iv 25 µg fentanyl. Postoperative Visual Analog Scale (VAS) and fentanyl consumption during the early two postoperative days were assessed. All patients were followed up over two months for occurrence of chronic post-sternotomy pain. RESULTS: VAS values showed high significant differences during the first 48 hours with the least pain scale in group 1 and significantly least fentanyl consumption (30.8 ± 7 µg in group 1 vs. 69 ± 18 µg in group 2, and 162 ± 3 in group 3 respectively). The incidence of chronic pain has not differed between the three groups although it was more pronounced in group 3. CONCLUSIONS: Continuous presternal bupivacaine and magnesium infusion resulted in better postoperative analgesia than both presternal bupivacaine alone or conventional analgesic groups.

Acetaminophen , Adjuvants, Anesthesia , Adult , Analgesia , Bupivacaine , Catheters , Chronic Pain , Double-Blind Method , Fentanyl , Humans , Incidence , Ketorolac , Magnesium Sulfate , Magnesium , Thoracic Surgery , Visual Analog Scale
Anaesthesia, Pain and Intensive Care. 2017; 21 (1): 59-64
in English | IMEMR | ID: emr-187464


Aims and Background: To prolong postoperative analgesia many adjuvants has been used opioids and alpha-2 agonists are very popular among them. This study was aimed at comparing the sensory, motor, hemodynamic, sedative and analgesic properties of epidural administration of fentanyl and dexmedetomidine as an adjuvant to ropivacaine

Methodology: With Institutional ethical committee clearance this study was conducted at our hospital. After obtaining informed and written consent, a total of 60 patients scheduled for elective percutaneous nephrolithotomy [PCNL] were randomly allocated into two groups of 30 each. Patients of both genders, aged 21-60 y, ASA physical status I and II were enrolled. Group RD received 28 ml of inj ropivacaine 0.5% + dexmedetomidine 1 ng/kg and Group RF received 28 ml of ropivacaine 0.5% + inj fentanyl 1 pig/kg epidurally. Hemodynamic parameters, sedation scores, and time to onset of sensory loss, complete motor blockade, two segmental dermatomal regression and time of first rescue analgesic were recorded. Data were compiled systematically and analyzed using unpaired t-test, Chi-square and Mann-Whitney U test. P < 0.05 was considered significant

Results: The demographic profile of patients was comparable in both groups. Onset of sensory analgesia up to T10 was 6.8 +/- 2.8 min vs. 8.7 +/- 2.7 min and time to reach maximum motor block was 19.8 +/- 5.8 min vs. 23.9 +/- 4.9 min in Group RD and Group RF respectively, which was significantly less in the Group RD. Postoperative analgesia was significantly prolonged in the Group RF as compared to Group RD, e.g. 394.5 +/- 36.5 vs. 268.5 +/- 28.3 min respectively. Sedation scores were better in the Group RD and highly significant on statistical comparison [P < 0.001]. Incidence of hypotension, nausea and vomiting was high in the Group RF, while incidence of dry mouth was higher in the Group RD

Conclusion: Dexmedetomidine is a better adjuvant than fentanyl when added to epidural ropivacaine in terms of early onset of sensory and motor block, prolonged postoperative analgesia and better sedation with less side effects

Adult , Female , Humans , Male , Middle Aged , Young Adult , Fentanyl/therapeutic use , Amides/therapeutic use , Adjuvants, Anesthesia , Anesthesia, Epidural , Nephrolithotomy, Percutaneous
Anaesthesia, Pain and Intensive Care. 2017; 21 (1): 65-78
in English | IMEMR | ID: emr-187465


Background: Subarachnoid block is still the most commonly used anesthetic technique for lower abdominal surgeries, however local anesthetics alone are associated with relatively short duration of action.The intrathecal adjuvants has been reported to improve the quality of anesthesia along with prolongation of postoperative analgesia and has gained popularity nowadays. So the aim of our study was to compare the dexmedetomidine and fentanyl as intrathecal adjuvant to 0.5% hyberbaric 0.396 bupivacaine with regards respect to onset and duration of sensory and motor block, duration of analgesia, hemodynamic variations and incidence of side effects

Material and Methods: Sixty four female patients, aged 30-60 years, belonging to American Society of Anesthesiologists [ASA] physical status I or II, scheduled for elective total abdominal hysterectomy with or without bilateral salpingo-oophorectomy were randomly allocated into two groups, Group BD received 2.5 ml of 0.5% hyperbaric bupivacaine and 5 microg dexmedetomidine diluted in 0.5 ml preservative free normal saline while Group BF received 2.5 ml of 0.5% hyperbaric bupivacaine and 25microg [0.5 ml] fentanyl

Results: There was no statistically significant difference between two groups with respect to onset of sensory and motor block, [p > 0.05]. The mean time for two segment sensory regression was significantly slower in Group BD as compared to Group BF, [p < 0.05]. Patients in Group BD had significantly prolonged duration of sensory and motor block as compared to Group BF [p < 0.05]. Similarly the duration of analgesia was significantly prolonged in Group BD [p < 0.05], along with reduced requirement of rescue analgesics. The patients in both groups did not show any significant difference with respect to hemodynamic changes and incidence of side effects [p > 0.05]

Conclusion: Dexmedetomidine as intrathecal adjuvant was found to have prolonged sensory and motor block, provide good quality of intraoperative analgesia, stable hemodynamics, minimal side effects and prolonged postoperative analgesia along with reduced demand for rescue analgesics as compared to fentanyl

Adult , Humans , Middle Aged , Female , Subarachnoid Space , Injections, Spinal , Dexmedetomidine/therapeutic use , Fentanyl/therapeutic use , Bupivacaine/analogs & derivatives , Adjuvants, Anesthesia , Prospective Studies , Double-Blind Method
Anaesthesia, Pain and Intensive Care. 2017; 21 (2): 194-198
in English | IMEMR | ID: emr-189146


Objectives: 0.5% bupivacaine used in subarachnoid block provides only about 3 hours of analgesia. Opioids especially morphine and fentanyl are used as adjuvants to produce extended postoperative analgesia. Nalbuphine is an agonist antagonist and does not require a narcotic license, which is a must for procuring other opioids, so is easily available even in peripheral hospitals. This study was carried out to evaluate the efficacy of nalbuphine versus fentanyl as intrathecal adjuvant

Methodology: One hundred ASA 1-3 patients, aged 30-65 years posted for elective total abdominal hysterectomy [TAH] were included in this study and were randomly divided into two groups of fifty each. Group FB received 15 mg of 0.5% bupivacaine [3 ml] plus 25 micro g of fentanyl [0.5 ml] and Group NB received 15 mg 0.5% bupivacaine [3 ml] plus 1 mg nalbuphine [0.5 ml]. No sedative or analgesic was given preoperatively. The parameters noted were; the time for sensory block to reach T10 dermatome, time for the sensory level to fall from T6 to T8 dermatome, time for the first request of rescue analgesia, duration of motor block and any untoward side effect or complications. The statistical analysis was performed by STATA 11.2 [College Station TX USA]. Students t-test were performed for to find the significance difference between the study parameters

Results: The onset of sensory blockade, time to attain peak sensory block and complete motor block was significantly faster in Group FB [p < 0.001]. The duration of motor block was comparable in both the groups. The time for sensory block to regress by two segments was significantly longer in Group NB, 97.72 +/- 9.50 min, than in Group FB, 88.88 +/- 9.48 min. The time to first analgesic requirement in Group NB was 460.78 +/- 77.98 min compared to 283.44 +/- 78.97 min in Group FB [p < 0.001]. No statistical difference was seen in terms of adverse effects. Two patients in both groups complained of nausea. Hypotension and pruritus were seen in two and one patient respectively in Group FB

Conclusion: Although the time to onset and peak sensory level is longer with nalbuphine as intrathecal adjuvant than fentanyl, time for sensory level to regress by two segments and the postoperative analgesia time is longer with nalbuphine. So, nalbuphine is a good adjuvant in spinal anesthesia and has an advantage in centers without narcotics license

Humans , Female , Adult , Middle Aged , Aged , Nalbuphine/pharmacology , Injections, Spinal , Hysterectomy , Prospective Studies , Adjuvants, Anesthesia
Braz. j. med. biol. res ; 50(12): e6346, 2017. tab, graf
Article in English | LILACS | ID: biblio-888962


This study evaluated the anesthetic potential of thymol and carvacrol, and their influence on acetylcholinesterase (AChE) activity in the muscle and brain of silver catfish (Rhamdia quelen). The AChE activity of S-(+)-linalool was also evaluated. We subsequently assessed the effects of thymol and S-(+)-linalool on the GABAergic system. Fish were exposed to thymol and carvacrol (25, 50, 75, and 100 mg/L) to evaluate time for anesthesia and recovery. Both compounds induced sedation at 25 mg/L and anesthesia with 50-100 mg/L. However, fish exposed to carvacrol presented strong muscle contractions and mortality. AChE activity was increased in the brain of fish at 50 mg/L carvacrol and 100 mg/L thymol, and decreased in the muscle at 100 mg/L carvacrol. S-(+)-linalool did not alter AChE activity. Anesthesia with thymol was reversed by exposure to picrotoxin (GABAA antagonist), similar to the positive control propofol, but was not reversed by flumazenil (antagonist of benzodiazepine binding site), as observed for the positive control diazepam. Picrotoxin did not reverse the effect of S-(+)-linalool. Thymol exposure at 50 mg/L is more suitable than carvacrol for anesthesia in silver catfish, because this concentration did not cause any mortality or interference with AChE activity. Thymol interacted with GABAA receptors, but not with the GABAA/benzodiazepine site. In contrast, S-(+)-linalool did not act in GABAA receptors in silver catfish.

Animals , Acetylcholinesterase/metabolism , Anesthetics/pharmacology , Catfishes , Monoterpenes/pharmacology , Receptors, GABA-A/metabolism , Thymol/pharmacology , Acetylcholinesterase/physiology , Adjuvants, Anesthesia/pharmacology , Analysis of Variance , Anesthesia/veterinary , Brain/drug effects , Brain/enzymology , Catfishes/metabolism , Diazepam/pharmacology , GABA Antagonists/pharmacology , Muscles/drug effects , Muscles/enzymology , Oils, Volatile/chemistry , Picrotoxin/pharmacology , Receptors, GABA-A/physiology , Reproducibility of Results , Statistics, Nonparametric , Time Factors
Article in English | WPRIM | ID: wpr-158010


BACKGROUND: Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60–80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy. METHODS: Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0.3–0.5 µg/kg/h; 2) the remifentanil group (group R), who received remifentanil at an initial target effect site concentration of 4 ng/ml during the induction of anesthesia, followed by a target effect site concentration of 2–3 ng/ml. PONV was assessed during the first 24 hours in 2 time periods (0–2 h and 2–24 h). The pain intensity, sedation score, extubation time, and hemodynamics were also assessed. RESULTS: During the 2 time periods, the incidence and severity of PONV in group D were significantly lower than in group R. In addition, the need for rescue antiemetics was significantly lower in group D than in group R. The effect of dexmedetomidine on postoperative pain relief (2–24 h) was superior to that of remifentanil. The hemodynamics were similar in both groups, whereas eye opening and extubation time were delayed in group D. CONCLUSIONS: Adjuvant use of intraoperative dexmedetomidine infusion may be effective for the prevention of PONV.

Adjuvants, Anesthesia , Anesthesia , Anesthesia, General , Antiemetics , Balanced Anesthesia , Dexmedetomidine , Hemodynamics , Humans , Incidence , Pain, Postoperative , Postoperative Nausea and Vomiting , Thyroidectomy
Acta cir. bras ; 31(8): 520-526, Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-792414


ABSTRACT PURPOSE: To evaluated the long-term effect of scopolamine and sesame oil on spatial memory. METHODS: Memory impairment induced by Intracerebroventricular (ICV) injection of scopolamine hydrochloride (10 μg/ rat). Animals were gavaged for 4 weeks with saline, sesame oil (0.5, 1, or 2 mL/kg/day), or 3 weeks with memantine (30 mg/kg/day) in advance to induction of amnesia. Morris water maze (MWM) test was conducted 6 days after microinjection of scopolamine. Then, blood and brain samples were collected and evaluated for the malondialdehyde (MDA) levels, superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities, and total antioxidant status (TAS) and ferric reducing ability of plasma (FRAP). RESULTS: Scopolamine significantly decreased traveled distance and time spent in target quadrant in probe test. Pretreatment of rats with sesame oil (0.5 mg/kg) mitigated scopolamine-induced behavioral alterations. Measurement of MDA, SOD, and GPX in brain tissue, and FRAP and TAS in blood showed little changes in animals which had received scopolamine or sesame oil. CONCLUSIONS: Intracerebroventricular injection of scopolamine has a residual effect on memory after six days. Sesame oil has an improving effect on spatial memory; however this effect is possibly mediated by mechanisms other than antioxidant effect of sesame oil.

Animals , Male , Rats , Scopolamine/adverse effects , Sesame Oil/administration & dosage , Amnesia/drug therapy , Adjuvants, Anesthesia/adverse effects , Antioxidants/administration & dosage , Superoxide Dismutase/chemistry , Ferric Compounds/chemistry , Rats, Wistar , Oxidative Stress/drug effects , Maze Learning , Disease Models, Animal , Alzheimer Disease/prevention & control , Glutathione Peroxidase/chemistry , Amnesia/chemically induced , Injections, Intraventricular , Memory/drug effects , Antioxidants/chemistry
Rev. bras. cir. cardiovasc ; 31(3): 213-218, May.-June 2016. tab, graf
Article in English | LILACS | ID: lil-796126


ABSTRACT Objective: α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery. Methods: We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group). Results: A total of 1302 patients who underwent cardiac surgery, either coronary artery bypass graft or valve surgery, were included; 796 in the DEX group and 506 in the CON group. Need for reoperation (2% vs. 2.8%, P=0.001), type 1 neurological injury (2% vs. 4.7%, P=0.005) and prolonged hospitalization (3.1% vs. 7.3%, P=0.001) were significantly less frequent in the DEX group than in the CON group. Thirty-day mortality rates were 3.4% in the DEX group and 9.7% in the CON group (P<0.001). Using multivariable Cox regression analysis with in hospital death as the dependent variable, dexmedetomidine was independently associated with a lower risk of 30-day mortality (odds ratio [OR]=0.39, 95% confidence interval [CI]: 0.24-0.65, P≤0.001). The Logistic EuroSCORE (OR=1.05, 95% CI: 1.02-1.10, P=0.004) and age (OR=1.03, 95% CI: 1.01-1.06, P=0.003) were independently associated with a higher risk of 30-day mortality. Conclusion: Dexmedetomidine used as an anesthetic adjuvant was associated with better outcomes in patients undergoing coronary artery bypass graft and valve surgery. Randomized prospective controlled trials are warranted to confirm our results.

Humans , Male , Female , Middle Aged , Aged , Postoperative Care/mortality , Coronary Artery Bypass/mortality , Dexmedetomidine/administration & dosage , Heart Valve Diseases/mortality , Adjuvants, Anesthesia/administration & dosage , Postoperative Period , Survival Analysis , Retrospective Studies , Cohort Studies , Hospital Mortality , Receptors, Adrenergic, alpha-2/administration & dosage , Heart Valve Diseases/surgery , Intensive Care Units/statistics & numerical data
Article in English | WPRIM | ID: wpr-48905


BACKGROUND: The purpose of this study was to evaluate the effect of dexamethasone or dexmedetomidine added to ropivacaine on the onset and duration of ultrasound-guided axillary brachial plexus blocks (BPB). METHODS: Fifty-one ASA physical status I-II patients with elective forearm and hand surgery under axillary brachial plexus blocks were randomly allocated to receive 20 ml of 0.5% ropivacaine with 2 ml of isotonic saline (C group, n = 17), 20 ml of 0.5% ropivacaine with 2 ml (10 mg) of dexamethasone (D group, n = 17) or 20 ml of 0.5% ropivacaine with 2 ml (100 microg) of dexmedetomidine (DM group, n = 17). A nerve stimulation technique with ultrasound was used in all patients. The onset time and duration of sensory blocks were assessed. RESULTS: The duration of the sensory block was extended in group D and group DX compared with group C (P < 0.05), but there was no significant difference between group D and group DX. However, there were no significant differences in onset time in all three groups. CONCLUSIONS: Dexamethasone 10 mg and dexmedetomidine 100 microg were equally effective in extending the duration of ropivacaine in ultrasound-guided axillary BPB with nerve stimulation. However, neither drug has significantly effects the onset time.

Adjuvants, Anesthesia , Analgesia , Brachial Plexus , Dexamethasone , Dexmedetomidine , Forearm , Hand , Humans , Ultrasonography
Rev. Assoc. Med. Bras. (1992) ; 61(4): 362-367, July-Aug. 2015. tab
Article in English | LILACS | ID: lil-761714


SummaryObjective:to compare the efficacy of two analgesia protocols (ketamine versus morphine) associated with midazolam for the reduction of dislocations or closed fractures in children.Methods:randomized clinical trial comparing morphine (0.1mg/kg; max 5mg) and ketamine (2.0mg/kg, max 70mg) associated with midazolam (0.2mg/kg; max 10mg) in the reduction of dislocations or closed fractures in children treated at the pediatrics emergency room (October 2010 and September 2011). The groups were compared in terms of the times to perform the procedures, analgesia, parent satisfaction and orthopedic team.Results:13 patients were allocated to ketamine and 12 to morphine, without differences in relation to age, weight, gender, type of injury, and pain scale before the intervention. There was no failure in any of the groups, no differences in time to start the intervention and overall procedure time. The average hospital stay time was similar (ketamine = 10.8+5.1h versus morphine = 12.3+4.4hs; p=0.447). The median pain (faces pain scale) scores after the procedure was 2 in both groups. Amnesia was noted in 92.3% (ketamine) and 83.3% (morphine) (p=0.904). Parents said they were very satisfied in relation to the analgesic intervention (84.6% in the ketamine group and 66.6% in the morphine group; p=0.296). The satisfaction of the orthopedist regarding the intervention was 92.3% in the ketamine group and 75% in the morphine group (p=0.222).Conclusion:by producing results similar to morphine, ketamine can be considered as an excellent option in pain management and helps in the reduction of dislocations and closed fractures in pediatric emergency rooms.

ResumoObjetivo:comparar a eficácia de dois protocolos de analgesia (cetamina versus morfina) associados ao midazolam para a redução de luxações ou fraturas fechadas em crianças.Métodos:ensaio clínico randomizado comparando morfina (0,1 mg/kg; máx. 5 mg) e cetamina (2,0 mg/kg; máx. 70 mg) associados a midazolam (0,2 mg/kg; máx. 10 mg) na redução de luxações ou fraturas fechadas em crianças atendidas em emergência pediátrica, no período de outubro de 2010 a setembro de 2011. Os grupos foram comparados segundo os seguintes indicadores: tempo para realizar os procedimentos, analgesia, satisfação de pais e da equipe ortopédica.Resultados:treze pacientes foram alocados para cetamina e 12 para morfina, sem diferenças em relação a idade, peso, gênero, tipo de lesão e escala da dor antes da intervenção. Não houve falha em nenhum dos grupos, sem diferenças no tempo para iniciar a intervenção e no tempo total de procedimento. O tempo médio de hospitalização foi similar (cetamina=10,8±5,1 h versus morfina=12,3±4,4 h; p=0,447). A mediana de dor (escala de faces da dor) após o procedimento foi de 2 em ambos os grupos. Amnésia foi observada em 92,3% (cetamina) e 83,3% (morfina) (p=0,904). Os pais declararam estar muito satisfeitos em relação à intervenção analgésica (84,6% no grupo cetamina e 66,6% no grupo morfina; p=0,296). A satisfação do ortopedista em relação à intervenção foi de 92,3% no grupo cetamina e 75% no grupo da morfina (p=0,222).Conclusão:a cetamina, ao apresentar resultados semelhantes à morfina, pode ser considerada uma excelente opção no manejo da dor e no auxílio da redução de luxações e fraturas fechadas em salas de emergência pediátrica.

Child , Child, Preschool , Female , Humans , Male , Analgesics , Adjuvants, Anesthesia/administration & dosage , Analgesia/standards , Joint Dislocations/therapy , Fractures, Closed/therapy , Ketamine , Midazolam , Morphine , Analgesics, Opioid/administration & dosage , Clinical Protocols/standards , Emergencies , Emergency Service, Hospital/standards , Pain Measurement , Time Factors , Treatment Outcome
Yonsei Medical Journal ; : 1627-1631, 2015.
Article in English | WPRIM | ID: wpr-70410


PURPOSE: To investigate the prevalence of paralytic ileus after spinal operation in the supine or prone operative position and to determine the efficacy of prophylactic gastrointestinal motility medications in preventing symptomatic paralytic ileus after a spinal operation. MATERIALS AND METHODS: All patients received spinal surgery in the supine or prone operative position. The study period was divided into two phases: first, to analyze the prevalence of radiographic and symptomatic paralytic ileus after a spinal operation, and second, to determine the therapeutic effects of prophylactic gastrointestinal motility medications (postoperative intravenous injection of scopolamine butylbromide and metoclopramide hydrochloride) on symptomatic paralytic ileus after a spinal operation. RESULTS: Basic demographic data were not different. In the first phase of this study, 27 patients (32.9%) with radiographic paralytic ileus and 11 patients (13.4%) with symptomatic paralytic ileus were observed. Radiographic paralytic ileus was more often noted in patients who underwent an operation in the prone position (p=0.044); whereas the occurrence of symptomatic paralytic ileus was not different between the supine and prone positioned patients (p=0.385). In the second phase, prophylactic medications were shown to be ineffective in preventing symptomatic paralytic ileus after spinal surgery [symptomatic paralytic ileus was observed in 11.1% (4/36) with prophylactic medication and 16.7% (5/30) with a placebo, p=0.513]. CONCLUSION: Spinal surgery in the prone position was shown to increase the likelihood of radiographic paralytic ileus occurrence, but not symptomatic paralytic ileus. Unfortunately, the prophylactic medications to prevent symptomatic paralytic ileus after spine surgery were shown to be ineffective.

Adjuvants, Anesthesia/administration & dosage , Adult , Aged , Antiemetics/administration & dosage , Female , Gastrointestinal Motility/drug effects , Humans , Injections, Intravenous , Intestinal Pseudo-Obstruction/drug therapy , Lumbar Vertebrae/diagnostic imaging , Male , Metoclopramide/administration & dosage , Middle Aged , Postoperative Complications/epidemiology , Prevalence , Prone Position , Prospective Studies , Republic of Korea , Scopolamine/administration & dosage , Spinal Fusion/adverse effects , Supine Position , Treatment Outcome
Rev. bras. anestesiol ; 64(4): 221-226, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-720468


BACKGROUND AND OBJECTIVES: A review of all the adjuncts for intravenous regional anaesthesia concluded that there is good evidence to recommend NonSteroidal Anti-Inflammatory agents and pethidine in the dose of 30 mg dose as adjuncts to intravenous regional anaesthesia. But there are no studies to compare pethidine of 30 mg dose to any of the NonSteroidal Anti-Inflammatory agents. METHODS: In a prospective, randomized, double blind study, 45 patients were given intravenous regional anaesthesia with either lignocaine alone or lignocaine with pethidine 30 mg or lignocaine with ketprofen 100 mg. Fentanyl was used as rescue analgesic during surgery. For the first 6 h of postoperative period analgesia was provided by fentanyl injection and between 6 and 24 h analgesia was provided by diclofenac tablets. Visual analogue scores for pain and consumption of fentanyl and diclofenac were compared. RESULTS: The block was inadequate for one case each in lignocaine group and pethidine group, so general anaesthesia was provided. Time for the first dose of fentanyl required for postoperative analgesia was significantly more in pethidine and ketoprofen groups compared to lignocaine group (156.7 ± 148.8 and 153.0 ± 106.0 vs. 52.1 ± 52.4 min respectively). Total fentanyl consumption in first 6 h of postoperative period was less in pethidine and ketoprofen groups compared to lignocaine group (37.5 ± 29.0 mcg, 38.3 ± 20.8 mcg vs. 64.2 ± 27.2 mcg respectively). Consumption of diclofenac tablets was 2.4 ± 0.7, 2.5 ± 0.5 and 2.0 ± 0.7 in the control, pethidine and ketoprofen group respectively, which was statistically not significant. Side effects were not significantly different between the groups. CONCLUSION: Both pethidine and ketoprofen are equally effective in providing postoperative analgesia up to 6 h, without significant difference in the side effects and none of the adjuncts provide significant ...

JUSTIFICATIVA E OBJETIVOS: uma revisão de todos os adjuvantes para anestesia regional intravenosa concluiu que há boas evidências para recomendar os agentes anti-inflamatórios não esteroides e petidina em dose de 30 mg como adjuvantes para anestesia regional intravenosa. Porém, não há estudos que comparem petidina (30 mg) com quaisquer dos agentes anti-inflamatórios não esteroides. MÉTODOS: em um estudo prospectivo, randômico e duplo-cego, 45 pacientes receberam anestesia regional intravenosa com apenas lidocaína ou lidocaína com petidina (30 mg) ou lidocaína com cetoprofeno (100 mg). Fentanil foi usado como analgésico de resgate durante a cirurgia. Durante as seis primeiras horas de pós-operatório, analgesia foi fornecida via injeção de fentanil e, entre seis e 24 horas, analgesia foi fornecida via comprimidos de diclofenaco. Os escores visuais analógicos para dor e do consumo de fentanil e diclofenaco foram comparados. RESULTADOS: o bloqueio foi inadequado para um caso tanto do grupo lidocaína quanto do grupo petidina; portanto, anestesia geral foi administrada. O tempo para a primeira dose necessária de fentanil para analgesia pós-operatória foi significativamente maior nos grupos petidina e cetoprofeno em comparação com o grupo lidocaína (156,7 ± 148,8 e 153,0 ± 106,0 vs. 52,1 ± 52,4 minutos, respectivamente). O consumo total de fentanil nas primeiras seis horas de pós-operatório foi menor nos grupos petidina e cetoprofeno em comparação com o grupo lidocaína (37,5 ± 29,0 mcg, 38,3 ± 20,8 mcg vs. 64,2 ± 27,2 mcg, respectivamente). O consumo de comprimidos de diclofenaco foi de 2,4 ± 0,7, 2,5 ± 0,5 e 2,0 ± 0,7 no grupo controle, petidina e cetoprofeno, respectivamente, o que não foi estatisticamente significante. ...

JUSTIFICACIÓN Y OBJETIVOS: una revisión sobre todos los adyuvantes para la anestesia regional intravenosa concluyó que hay buenas evidencias para recomendar los agentes antiinflamatorios no esteroideos y la petidina en dosis de 30 mg como adyuvantes para la anestesia regional intravenosa. Sin embargo, no hay estudios comparando la petidina (30 mg) con cualesquiera de los agentes antiinflamatorios no-esteroideos. MÉTODOS: en un estudio prospectivo, aleatorizado y doble ciego, 45 pacientes recibieron anestesia regional intravenosa con solamente lidocaína o lidocaína con petidina (30 mg) o lidocaína con ketoprofeno (100 mg). El fentanilo fue usado como analgésico de rescate durante la cirugía. Durante las 6 primeras horas del postoperatorio, la analgesia fue suministrada vía inyección de fentanilo y entre 6 y 24 h, la analgesia fue suministrada vía comprimidos de diclofenaco. Se compararon las puntuaciones visuales analógicas para el dolor y el consumo de fentanilo y diclofenaco. RESULTADOS: el bloqueo fue inadecuado para un caso tanto del grupo lidocaína como del grupo petidina; por tanto, se administró anestesia general. El tiempo para la primera dosis necesaria de fentanilo para analgesia postoperatoria fue significativamente mayor en los grupos petidina y ketoprofeno en comparación con el grupo lidocaína (156,7 ± 148,8 y 153,0 ± 106,0 vs. 52,1 ± 52,4 min, respectivamente). El consumo total de fentanilo en las primeras 6 h del postoperatorio fue menor en los grupos petidina y ketoprofeno en comparación con el grupo lidocaína (37,5 ± 29,0 mcg; 38,3 ± 20,8 mcg vs. 64,2 ± 27,2 mcg, respectivamente). El consumo de comprimidos de diclofenaco fue de 2,4 ± 0,7; 2,5 ± 0,5; y 2 ± 0,7 en el grupo control, petidina y ketoprofeno, respectivamente, lo que no fue estadísticamente significativo. Los ...

Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anesthesia, Conduction/methods , Ketoprofen/administration & dosage , Lidocaine/administration & dosage , Meperidine/administration & dosage , Adjuvants, Anesthesia/administration & dosage , Adjuvants, Anesthesia/adverse effects , Anesthesia, Conduction/adverse effects , Anesthesia, Intravenous/adverse effects , Anesthesia, Intravenous/methods , Anesthetics, Local/administration & dosage , Anesthetics, Local/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Double-Blind Method , Diclofenac/administration & dosage , Fentanyl/administration & dosage , Ketoprofen/adverse effects , Lidocaine/adverse effects , Meperidine/adverse effects , Pain Measurement , Prospective Studies , Pain, Postoperative/prevention & control , Time Factors