Analgesia intra-articular com morfina, bupivacaína ou fentanil após operação de joelho por videoartroscopia

Abstract

RESUMO

Bupivacaina ou bupivacaina e morfina intra-articular pós reconstrução do LCA

“…The control group had greater use of rescue medication (three cases), while no other group required such use, similar to other published studies 3,6,10 suggesting that even the use of bupivacaine alone, associated with this type of anesthesia, has a good effect on pain control.…”

“…The epidural anesthesia can decrease the effect of morphine by diminishing the neuroendocrine response to surgical trauma and reducing the release of inflammatory mediators. 1,3 Eroglu et al 11 compared the effect of bupivacaine and of intra-articular morphine with placebo on patients submitted to knee arthroscopy under spinal anesthesia, yet excluding the patients selected to undergo ACL reconstruction, and obtained optimal pain control, but the VAS values were even higher than our results.…”

“…Among these complications only nausea and vomiting are more frequent, representing complications inherent to the type of anesthesia used (spinal block). 3 Eroglu et al, 11 in a similar survey using spinal anesthesia and applying bupivacaine, morphine or saline solution, obtained similar complications, and a patient from the group that used morphine also evolved with urine retention.…”

“…Thus many surveys address the best form of analgesia for this surgery and how to use fewer drugs for this purpose, decreasing the side effects. 3 When peripheral opioid receptors were evidenced mainly in the swollen tissues, this opened up the possibility of using peripheral opioid administration in an attempt to tap into the high analgesic power of these medications, at the same time avoiding their undesirable central effects. Within this arsenal we have the intra-articular application of drugs, of which the most common are bupivacaine and morphine.…”

Eficácia analgésica do uso da dextrocetamina intra-articular em pacientes submetidos a artroplastia total do joelho

“…Patients were evaluated postoperatively at t1 (2h), T2 (6h), T3 (12h), and T4 (24h) based on earlier publications and assessment division of post-operative pain in three phases: early (0-2h) in which the residual effect of anesthesia/analgesia administered intraoperatively could lead to a bias in the study; intermediate (2-6h) in which the effect of these drugs usually start to decrease, and late (6-24h) in which the present analgesic effect would be predominantly local [36][37][38] .…”