Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942012000100004
Brazilian Journal of Anesthesiology
Scientific Article

Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

Postoperative analgesic efficacy of different volumes and masses of ropivacaine in posterior brachial plexus block

Bruno Salome de Morais; Marcos Guilherme Cunha Cruvinel; Fabiano Soares Carneiro; Flavio Lago; Yerkes Pereira Silva

http://dx.doi.org/10.1590/S0034-70942012000100004 Braz J Anesthesiol, vol.62, n1, p.23-27, 2012
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Resumo

JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial pela via posterior tem sua eficácia para cirurgias de ombro demonstrada por diferentes autores. Entretanto, não há um consenso sobre a massa e o volume ideal de anestésico local a ser empregado. O objetivo deste estudo é com parar diferentes volumes e massas de ropivacaína no bloqueio do plexo braquial pela via posterior em cirurgias artroscópicas de ombro. MÉTODO: Sessenta pacientes com idade > 18 anos, estado físico ASA I e II, escalados para cirurgias artroscópicas de ombro unilateral foram alocados aleatoriamente em três grupos: A (10 mL a 0,5%), B (20 mL a 0,5%), C (5 mL a 1%). O bloqueio foi realizado com agulha 22G de 100 mm conectada ao neuroestimulador, em um ponto 3 cm lateral ao ponto médio do interespaço de C6 e C7, sendo injetada a solução correspondente a cada grupo. A dor pós-operatória foi avaliada na SRPA e nas primeiras 24 horas do pós-operatório. Os grupos foram comparados quanto ao tempo para primeira queixa de dor, à pontuação na ENV e ao consumo de morfina nas primeiras 24 horas. RESULTADOS: Não houve diferença estatisticamente significativa entre os três grupos em relação a idade, peso e altura. Não houve diferença no tempo até a primeira queixa de dor, ENV superior a três e consumo de morfina no pós-operatório entre os grupos. CONCLUSÕES: O presente estudo concluiu que 5 mL de ropivacaína 1% promoveu eficácia analgésica similar a 10 mL ou 20 mL de ropivacaína 0,5% no bloqueio do plexo braquial pela via posterior com o uso do neuroestimulador

Palavras-chave

ANESTÉSICOS, CIRURGIA, DOR, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: The efficacy of posterior brachial plexus block for shoulder surgeries is demonstrated by different authors. However, there is no consensus on the ideal mass and volume of local anesthetic to be employed. The objetive of this study was to compare different volumes and masses of ropivacaine in posterior brachial plexus block in arthroscopic surgeries of the shoulder. METHOD: Sixty patients > 18 years, physical status ASA I and II, scheduled for unilateral arthroscopic surgeries of the shoulder were randomly placed in three groups: A (10 mL to 0.5%), B (20 mL to 0.5%), C (5 mL to 1%). The block was performed with a 22G needle of 100 mm connected to neurostimulator, in a point 3 cm lateral to the midpoint of C6 and C7 interspace, being injected the solution corresponding to each group. The postoperative pain was evaluated at the recovery room and within the first 24 hours of the postoperative period. The groups were compared on length of time until the first complaint of pain, visual numeric scale (VNS) score and morphine consumption within the first 24 hours. RESULTS: There was no statistically significant difference between the three groups related to age, weight and height. There was no difference in length of time until the first complaint of pain, VNS scores over three and morphine consumption in the postoperative period between the groups. CONCLUSIONS: This study concluded that 5 mL of 1% ropivacaine promoted analgesic efficacy similar to 10 mL or 20 mL of 0.5% ropivacaine in the posterior brachial plexus block using neurostimulator

Keywords

Anesthetics, Pain Measurement, Orthopedics, Brachial Plexus

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