Navegando por Palavras-chave "PAIN, Acute"

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    Analgesia pós-operatória em pacientes pediátricos: estudo comparativo entre anestésico local, opióides e antiinflamatório não esteróide
    (Sociedade Brasileira de Anestesiologia, 2002-04-01) Menezes, Miriam Seligman [UNIFESP]; Gozzani, Judymara Lauzi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UFSM CET Prof. Manoel Alvarez
    BACKGROUND AND OBJECTIVES: The treatment of postoperative pain in children has been given special attention in the last decades. This study aimed at analyzing postoperative analgesia in children, considering analgesia quality and duration, evaluation methods reliability and the incidence of side effects resulting from different analgesia techniques. METHODS: Participated in this study 100 children, aged 2 to 12 years, allocated in 5 groups of 20 children each, who received, right after anesthesia, the following analgesics: group B, 0.25% bupivacaine with epinephrine (1:400,000) 0.5 to 1 ml.kg-1; group F, 1.5 µg.kg-1 fentanyl; group M, 30 µg.kg-1 morphine; group S, 0.3 µg.kg-1 sufentanil, all by epidural caudal block and group D, who received rectal diclofenac (1 mg.kg-1). Pain was evaluated by two different methods: one, predominantly behavioral and objective and the other subjective and self-evaluated, during the first 4 hours and then up to the 24th hour. Side effects were observed and treated. RESULTS: In the first 4 hours, groups B, F, M and S patients presented similar behavior, with a minimum need for complementary analgesia. In the remaining 20 hours, the longest analgesia duration was seen in group S, which did not differ from groups F and M, but was significantly longer than for groups B and D. Rectal diclofenac has not promoted effective pain relief. There has been a higher incidence of side-effects in group M, which did not differ from group S, but was significantly higher than for groups F, B and D. There has been a positive and significant correlation between both pain scales. CONCLUSIONS: Spinal opioids are safe and effective for postoperative analgesia in children, but when compared to bupivacaine, there have been no significant differences and a higher incidence of side effects. Rectal diclofenac was not effective as a single analgesic as compared to other techniques.
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    Lombociatalgia: comparação da analgesia entre metilprednisolona, fentanil e metilprednisolona com fentanil, associados à bupivacaína, por via peridural
    (Sociedade Brasileira de Anestesiologia, 2001-10-01) Rocha, Quitéria Maria Wanderley [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]; Issy, Adriana Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Epidural steroids are used as an alternative for the treatment of low back pain refractory to conservative measures. Opioids exert their analgesic effect through binding to spinal cord receptors and may have an additive effect. This study aimed at evaluating efficacy, side-effects and complications of opioids and steroids associated to local anesthetics in the treatment of acute low back pain caused by herniated disks. METHODS: Participated in this study 45 adult patients with acute herniated disks. G-I received 8 ml of 0.25% bupivacaine with methylprednisolone acetate (80 mg); G-II received 8 ml of 0.25% bupivacaine with fentanyl (100 µg) and G-III received 6 ml of 0.25% bupivacaine with fentanyl (100 µg) and 80 mg methylprednisolone acetate. When needed, a new injection was administered after 1 week and 2 weeks into the herniated disk interspace or close to it. Analgesic effects were evaluated through a verbal scale. RESULTS: At 30 minutes, 6, 12 and 24 hours there were no differences among groups as to pain relief. In days 4, 7 and 14, groups G-I and G-III had better pain relief without statistical differences between them. Group II needed more repeated injections in days 7 (G-I = 33.3%; G-II = 100% and G-III = 33.3%) and 14 (G-I = 6.6%, G-II=86.6% and G-III = 6.6%). Tramadol was more frequently used in G-II. G-I referred headache (1 patient), G-II somnolence (2 patients) and pruritus (1 patient) and G-III pruritus (1 patient) and somnolence (1 patient). CONCLUSIONS: Fentanyl did not improve analgesia when associated either to epidural bupivacaine plus methylprednisolone or to plain bupivacaine.