Anestesia regional intravenosa com associaçåo de lidocaína - tenoxicam em cirurgia ortopédica de membro superior / Intravenous regional anesthesia with lidocaine - tenoxicam in orthopedic surgery on upper limbs

RESUMO

Background and Objectives - Intravenous regional anesthesia is an easy, safe, and reliable technique for surgery on the limbs, although it does not provide good post operative analgesia. Tenoxican is a non steroidal antiinflamatory drug which was developed for intravenous use. The purpose of this study was to evaluate if the asociation of tenoxicam to the lidocaine used as the local anesthetic for intravenous regional anesthesia further enhances the quality and duration of post operative analgesia in orthopedic surgery on the upper limbs. Methods - Seventy-five patients, allocated into 3 groups of 25, were studied. Group A received 2 ml of saline associated with the local anesthetic and 2 ml of saline intravenously in the contra-lateral lim. Group B receveid 20 mg de tenoxican intravenously in the contra-lateral limb. Group C received tenoxican 20 mg asociated with the local anesthetic. The following parameters were evaluated duration of postoperative analgesia, pain intensity, analgesic requirements and side effects. Results - Duration of postoperative analgesia was significantly longer and opioid requirements significantly less in the groups which received tenoxicam. The painless intervals were 23 +- 10 minutes in Group A, 89 +- 44 minutes in Group B (p< 0.01 as compared to A) and 417 +- 190 minutes in Group C (p<0.01 as compared to A and B). Side effects were similar in all groups. Conclusions - Data collected in this study demonstrate that the asociation of lidocaine and tenoxicam induces good quality of analgesia in the post operative period of orthopedic surgery, The duration of the analgesic effect of the asociation is significantly longer as compared to that of the local anesthetic alone. The administration of the two drugs in the same solution produces better results: