RESUMO
BACKGROUND: We evaluated the effectiveness of low-dose patient-controlled epidural analgesia (PCEA) in the patients undergoing laparoscopic gynecological surgery, and investigated the difference of postoperative pain between patients for laparoscopic ovarian cystectomy and those for myomectomy. METHODS: Thirteen patients (ASA PS 1 or 2), scheduled for laparoscopic surgery, were enrolled in this study. They were divided into two groups of ovarian cystectomy (group C, n=17) and myomectomy (group M, n=13). After administering epidural bolus of 0.2% ropivacaine 6 ml, droperidol 2.5 mg, and buprenorphine hydrochloride 0.1 mg, PCEA was started: 1 ml x hr(-1) background infusion; 0.2% ropivacaine 54 ml, droperidol 5 mg, and buprenorphine hydrochloride 0.3 mg; 1 ml epidural bolus with a 30-minute lockout interval. We evaluated postoperative pain using visual analogue scale (VAS) at rest and on movement, adverse effects such as respiratory and cardiovascular depression, nausea and vomiting for 48 hours after surgery. RESULTS: VAS at rest with group M was significantly higher than that of group C (11 +/- 2 vs. 6 +/- 2, P=0.048), and VAS on movement of group M was also higher than that of group C (25 +/- 3 vs. 18 +/- 2, P=0.023): however, we found good analgesic effect of less than VAS 3 in both groups. Severe adverse effects were not observed. CONCLUSIONS: These findings suggest that low dose PCEA is effective for patients who undergo laparoscopic gynecological surgery.
Assuntos
Analgesia Epidural/métodos , Analgesia Controlada pelo Paciente/métodos , Endometriose/cirurgia , Procedimentos Cirúrgicos em Ginecologia , Laparoscopia , Cistos Ovarianos/cirurgia , Dor Pós-Operatória/tratamento farmacológico , Adulto , Amidas/administração & dosagem , Analgesia Controlada pelo Paciente/efeitos adversos , Buprenorfina/administração & dosagem , Droperidol/administração & dosagem , Feminino , Humanos , RopivacainaRESUMO
We examine the effect of nasal sumatriptan as an adjunctive therapy in 3 patients with idiopathic trigeminal neuralgia refractory to carbamazepine (CBZ) and found that this therapy might be suitable for patients for whom the CBZ dose cannot be increased, who are under poor pain control, and who are not candidates for nerve blocks or surgery.
