Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942002000100003
Brazilian Journal of Anesthesiology
Scientific Article

Influência da medicação pré-anestésica com midazolam e clonidina no nível de hipnose após indução anestésica com propofol e alfentanil em crianças: monitorização pelo índice bispectral

Influence of midazolam and clonidine premedication on hypnosis level after anesthetic induction with propofol and alfentanil in children: bispectral index monitoring

Eliana Marisa Ganem; Norma Sueli Pinheiro Módolo; Pedro Thadeu Galvão Vianna; Yara Marcondes Machado Castiglia

http://dx.doi.org/10.1590/S0034-70942002000100003 Braz J Anesthesiol, vol.52, n1, p.19-23, 2002
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Resumo

JUSTIFICATIVA E OBJETIVOS: A medicação pré-anestésica (MPA) é adjuvante da anestesia e diminui tanto a necessidade de concentrações elevadas de anestésicos como a ansiedade perioperatória, produzindo amnésia e contribuindo para estabilidade hemodinâmica. Dentre as drogas administradas na MPA de crianças, encontram-se o midazolam e a clonidina. O objetivo desta pesquisa foi avaliar se a MPA com midazolam e clonidina exerce influência no nível de hipnose, avaliado pelo BIS, em crianças após indução anestésica com propofol e alfentanil. MÉTODO: Participaram do estudo 30 pacientes, com idades entre 2 e 12 anos, estado físico ASA I, submetidos a cirurgias eletivas, que foram distribuídos em 3 grupos: G1 - sem MPA, G2 - midazolam (0,5 mg.kg-1) e G3 - clonidina (4 µg.kg-1), por via oral, 60 minutos antes da cirurgia. Todos os pacientes receberam alfentanil (30 µg.kg-1), propofol (3 mg.kg-1) e atracúrio (0,5 mg.kg-1). Avaliou-se o valor derivado do BIS antes da indução da anestesia (M1) e após a intubação (M2). O método estatístico utilizado foi a análise de variância para idade, peso e altura, e análise de perfil para o BIS, sendo o valor de p < 0,05 considerado significativo. RESULTADOS: Quando se comparou o mesmo momento (M1 ou M2) entre os três grupos, não foram observadas diferenças estatisticamente significativas. Quando se compararam os dois momentos de um mesmo grupo, M1 foi maior que M2 nos três grupos. CONCLUSÕES: A medicação pré-anestésica com midazolam e clonidina não influenciou o nível de hipnose em crianças induzidas com propofol e alfentanil.

Palavras-chave

HIPNÓTICOS, HIPNÓTICOS, MEDICAÇÃO PRÉ-ANESTÉSICA, MEDICAÇÃO PRÉ-ANESTÉSICA, MONITORIZAÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Premedication is an anesthetic adjuvant which decreases both perioperative anxiety and the need for high anesthetic concentrations, in addition to producing amnesia and contributing to hemodynamic stability. Midazolam and clonidine are among preanesthetic drugs indicated for children. This study aimed at evaluating whether preanesthetic midazolam or clonidine influences hypnosis in children induced with propofol and alfentanil. METHODS: Participated in this study 30 patients aged 2 to 12 years, physical status ASA I, undergoing elective surgeries, who were divided into 3 groups: G1- without premedication, G2 - oral midazolam (0.5 mg.kg-1), and G3 - oral clonidine (4 µg.kg-1), both administered 60 minutes before anesthesia. All patients received alfentanil (30 µg.kg-1), propofol (3 mg.kg-1), and atracurium (0.5 mg.kg-1). BIS values were evaluated before anesthesia induction (M1) and after tracheal intubation (M2). Analysis of variance was the statistical method used for age, weight, and height, and profile analysis was used for BIS values, considering significant p < 0.05. RESULTS: In comparing the same moment (M1 or M2) among the three groups there were no significant differences. When comparing the two moments of a same group, M1 values were higher than M2 values in all groups. CONCLUSIONS: Midazolam and clonidine premedication have not influenced hypnosis level of propofol and alfentanil in children.

Keywords

HYPNOTICS, HYPNOTICS, MONITORING, PREANESTHETIC MEDICATION, PREANESTHETIC MEDICATION

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