Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942004000100013
Brazilian Journal of Anesthesiology
Miscellaneous

Influência da clonidina por via venosa no custo de anestesia com sevoflurano em cirurgias de ouvido médio em regime ambulatorial

Influence of intravenous clonidine in the cost of sevoflurane anesthesia for outpatient middle ear procedures

Renato Mestriner Stocche; Luís Vicente Garcia; Jyrson Guilherme Klamt; Marlene Paulino dos Reis; Daniela Rocha Gil; Karin Luiza Magno Mesquita

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Resumo

JUSTIFICATIVA E OBJETIVOS: A clonidina é um agente a2-agonista que diminui o consumo de anestésicos venosos e inalatórios. Este estudo visou avaliar a relação custo-benefício da medicação pré-anestésica com clonidina por via venosa em anestesia geral com sevoflurano em regime ambulatorial. MÉTODO: Trata-se de estudo encoberto, aleatório, controlado com placebo, realizado com pacientes com idade entre 15 e 52 anos. Os pacientes foram divididos em 3 grupos de 15: Grupo S (placebo), Grupo C3 (clonidina 3 µg.kg-1) e Grupo C5 (5 µg.kg-1). A indução anestésica foi feita com sevoflurano, alfentanil (30 µg.kg-1) e pancurônio (0,08 mg.kg-1). Foram anotados a freqüência de complicações, consumo de halogenados, tempo de anestesia, tempo de recuperação fase I e II. A análise de custos considerou gastos diretos e indiretos. RESULTADOS: Não houve diferenças entre os grupos em relação aos dados demográficos, freqüência de complicações e tempo para recuperação anestésica fase I. A recuperação anestésica fase II foi prolongada no grupo C5 (p < 0,05). O consumo de sevoflurano por minuto de cirurgia foi 0.54 ± 0,14 no grupo S e 0,33 ± 0,09 e 0,34 ± 0,13 nos grupos C3 e C5, respectivamente (p < 0,05). Nos grupos que receberam clonidina, o custo foi diminuído em aproximadamente 35%. CONCLUSÕES: A clonidina (3 µg.kg-1) por via venosa diminui o consumo de sevoflurano sem aumentar o tempo de recuperação fase II. A dose de 5 µg.kg-1, apesar de diminuir o consumo de sevoflurano, prolonga a recuperação fase II, não se adequando ao regime ambulatorial.

Palavras-chave

ANESTESIA, ANESTÉSICOS, Volátil, DROGAS, a2- agonista

Abstract

BACKGROUND AND OBJECTIVES: Clonidine is an a2-agonist which decreases intravenous and inhalational anesthetics consumption. This study aimed at evaluating the cost-benefit ratio of preanesthetic medication with intravenous clonidine for general anesthesia with sevoflurane in outpatient procedures.
METHODS: Forty five patients aged 15 to 52 years were included in this double-blind, randomized and placebo controlled study, and were distributed in 3 groups of 15: Group S (placebo), Group C3 (3 µg.kg-1 clonidine) and Group C5 (5 µg.kg-1 clonidine). Anesthesia was induced with sevoflurane, alfentanil (30 µg.kg-1) and pancuronium (0.08 mg.kg-1). The following parameters were recorded: incidence of complications, halogenate consumption and anesthesia duration, as well as phase I and II recovery time. Cost analysis has considered direct and indirect costs.
RESULTS: There were no differences among groups in demographics data, incidence of complications and phase I anesthetic recovery. Phase II anesthetic recovery was prolonged in Group C5 (p < 0.05). Sevoflurane consumption per minute of surgery was 0.54 ± 0.14, 0.33 ± 0.09 and 0.34 ± 0.13 in Groups S, C3 and C5 respectively (p < 0.05). Costs were approximately 35% lower in the clonidine groups.
CONCLUSIONS: Intravenous clonidine (3 µg.kg-1) decreases sevoflurane consumption without prolonging phase I recovery. Although decreasing sevoflurane consumption, 5 µg.kg-1 clonidine prolongs phase II recovery, thus being inadequate for outpatient procedures.

Keywords

ANESTHESIA: Ambulatory; ANESTHETICS, Volatile: sevoflurane; DRUGS, a2- agonist: clonidine

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