Uso de agonistas de los receptores opiáceos en anestesia epidural / Use of agonists opiate receptors in epidural anesthesia

RESUMEN

A partir de 1981 se ha venido ensayando la administración de opiáceos epidurales e intratecales con bastante éxito según reportes de la literatura, con complicaciones mínimas y previsibles. Este es el motivo por el cual presentamos este estudio comparativo de dos grupos de 20 pacientes cada uno con clasificación ASA I y ASA II intervenidos de cirugías de hemiabdomen inferior en las especialidades de Cirugía General, Ginecología y Urología. En grupo I recibió una dosis de anestésico local + Buprenorfina 0,2-0,3mg por vía epidural y el grupo II recibió una dosis de anestesia y analgesia, necesidad mínima de drogas transoperatorias, complicaciones trans y postoperatorias manejables por el anestesiólogo; sin embargo, el grupo I tuvo una analgesia postoperatoria más prolongada que el grupo II sometidos a cirugía de hemi-abdomen inferior ofrecen seguridad en el procedimiento sobre todo con el uso de Buprenorfina cuyo efecto analgésico es más prolongado.

ABSTRACT

Epidural and intraspinal narcotics have been successfully used since 1981. Literature reports that potential complications are minimal and serious side effects are rare, for this reason we present the following comparative study between two narcotic drugs administered by epidural route and local anesthetics in order to produce surgical anesthesia. 40 classifed Physical state ASA I, ASA II patients were chosen and divided into two groups of 20 patients each one. They had elective lower abdominal surgery in Gynecology – Urology and General surgical areas. Both groups received a single dose of local anesthetic by epidural route. Group I was administered buprenorfine 0,2 – 0,3mg and group II was adicionally given Nalbufine 5mg. results showed that anesthesia and analgesia were excellent, other transoperatory drugs were not needed and the complications were handled by anesthesiologists in good performance; however, Group I had longer analgesia in potoperatory period than group II. We concluded that opiates administered by epidural route are safe and offer prolongued postoperatory pain relief specially with buprenorfine.