Analgesia pós-operatória plexular contínua: estudo dos efeitos colaterais e do risco de infecção dos cateteres

Abstract

BACKGROUND AND OBJECTIVES:The importance of postoperative analgesia has increased over the years. Plexular catheters represent a good option for high quality analgesia with reduced systemic repercussions. The objective of the present study was to evaluate the incidence of side effects and complications in postoperative analgesia with plexular catheters and identify risk factors for bacterial colonization of the catheters. METHODS: Patients undergoing orthopedic surgeries betweenMarch of 2005 and January of 2007 received analgesia via plexular catheters. The incidence of side effects and complications of this technique were evaluated. In some of the cases, the catheter tip was cultured. RESULTS:Four hundred and thirty-three patients were evaluated. Urinary retention and nausea/vomiting had an incidence of 1.3 and 16.6%, respectively. Of 280 catheters examined, 8.6% were colonized. Infections, nerve lesions, or systemic repercussion were not observed. CONCLUSIONS:The use of antibiotics preoperatively and the type of needle were the risk factors of infection identified.

SBA 2020: Regional anesthesia safety recommendations update

“…Keeping epidural catheters in situ for an average of 56 hours without tunneling have shown 28% of positive cultures, with no correlation with the type of preoperative antibiotic administered. 123 According to a study involving 40,362 cases of peripheral and epidural catheters for continuous use, patients who received single-dose antibiotic prophylaxis had significant lower levels of peripheral catheter-related infections (1.1%) compared to those without prophylaxis (2.4%, p < 0.001, nnT = 76). In patients with an epidural catheter, single-dose antibiotic prophylaxis reduced the incidence of infections (3.1%) in comparison to those without prophylaxis (5.2%, p < 0.001, nnT = 49).…”

“…Administration of systemic antibiotics within 24 hours postoperatively significantly decreases the risk of catheter colonization. 98 , 123 …”

“… 98 Tunneling of long-term catheters is recommended in order to reduce colonization of catheter tips. 123 Handling short-term catheters should take place under aseptic technique with minimal handling of the catheter after insertion, use of transparent dressings, and surveillance of the puncture site two to three times a day, and the day following removal. In case of inflammatory signs at the site, catheter removal, catheter culture request and antibiotic treatment (ceftriaxone ‒ 2 g each 12 hours associated with vancomycin ‒ 1 g each 12 hours) are mandatory.…”

“…Tunneling of long-term catheters is recommended in order to reduce colonization of catheter tips. 123 …”

Análise da efetividade do bloqueio peridural em Bomba de Infusão Continua (BIC) no controle da dor em pós-operatório de cirurgia torácica

“…É importante ressaltar que procedimentos invasivos possuem efeitos colaterais como lesões venosas, intoxicação por anestésicos, infecção e migrações. Em especial, a bomba de infusão contínua pode causar principalmente hipotensão arterial, náuseas e vômitos (Gasparini et al 2008;Higashi et al 2019). Segundo Tomaszek et al (2019), a eficácia para o controle da dor nos pacientes depende do número de medidas para sua intervenção.…”