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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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.
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