Analgesia regional em cuidados intensivos

Luísa Guedes; Helena Rebelo; Raquel Oliveira; Aida Neves

doi:10.1590/S0034-70942012000500011

Review Article

Analgesia regional em cuidados intensivos

Regional analgesia in intensive care

Luísa Guedes; Helena Rebelo; Raquel Oliveira; Aida Neves

http://dx.doi.org/10.1590/S0034-70942012000500011 Braz J Anesthesiol, vol.62, n5, p.724-730, 2012

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Resumo

JUSTIFICATIVAS E OBJETIVOS: A analgesia regional desempenha um papel importante na abordagem multimodal da dor no doente crítico e permite amenizar o desconforto do doente e reduzir os estresses fisiológico e psicológico associados. Ao diminuir as doses de opioides sistêmicos, reduz alguns dos seus efeitos colaterais, como a síndrome de abstinência, possíveis alterações psicológicas e disfunção gastrintestinal. Apesar desses benefícios, seu uso é controverso, uma vez que os doentes em unidades de cuidados intensivos apresentam frequentemente contraindicações, como coagulopatia, instabilidade hemodinâmica e dificuldade na avaliação neurológica e na execução da técnica regional. CONTEÚDO: Os autores apresentam uma revisão sobre analgesia regional em cuidados intensivos, com foco nas principais vantagens e limitações de seu uso no doente crítico, e descrevem as técnicas regionais mais usadas e a sua aplicabilidade nesse contexto.

Palavras-chave

ANALGESIA, COMPLICAÇÕES, Generalidades, DOR, TÉCNICAS ANESTÉSICAS, Regional, TERAPIA INTENSIVA

Abstract

JUSTIFICATIONS AND OBJECTIVES: regional analgesia plays an important role in multimodal pain management in critically ill patients, minimizing patient discomfort and reducing the associated physiological and psychological stress. Lower doses of systemic opioids reduce some of its side effects, such as withdrawal syndrome, possible psychological changes, and gastrointestinal dysfunction. Despite these benefits, its use is controversial, as patients in intensive care units often have contraindications, such as coagulopathy, hemodynamic instability, and difficulty in neurological assessment and implementation of regional technique. CONTENT: The authors present a review of regional analgesia in intensive care, focusing on the main advantages and limitations of its use in critically ill patients, and describe the most commonly used regional techniques and its applicability.

Keywords

Analgesia, Anesthesia, Conduction, Pain, Intensive Care

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Analgesia regional em cuidados intensivos

Regional analgesia in intensive care

Luísa Guedes; Helena Rebelo; Raquel Oliveira; Aida Neves

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Abstract

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