Analgesia Epidural em Cirurgia de Escoliose em Idade Pediátrica

Autores

  • Sónia Dória Nóbrega Centro Hospitalar Universitário Lisboa Central
  • Ana Ferreira
  • Sara Ramos

DOI:

https://doi.org/10.25751/rspa.19016

Palavras-chave:

Analgesia Epidural; Criança; Dor Pós-Operatória/tratamento; Escoliose/cirurgia; Gestão da Dor

Resumo

Introdução: A cirurgia de escoliose pediátrica, que visa interromper a progressão da doença e melhorar a qualidade de vida, está associada a dor pós-operatória intensa. Em 2016, implementámos a analgesia
epidural no período pós-operatório, através de um ou dois cateteres epidurais, colocados pelo cirurgião no final da cirurgia. Os objetivos deste estudo foram avaliar a eficácia analgésica até 72 horas após a cirurgia, a incidência de eventos adversos e o tempo de permanência na Unidade de Cuidados Intensivos (UCI).

Material e Métodos: Foi realizada uma análise retrospectiva comparando dois grupos: Grupo Alfentanil (AG) - 25 doentes com analgesia sistémica por perfusão endovenosa de alfentanil - e Grupo Epidural (EG) - 21 doentes com perfusão de ropivacaína e morfina via epidural. Os dados foram analisados através do SPSS®, utilizando o teste não paramétrico de Mann-Whitney, o teste exato de Fisher e o coeficiente de correlação de Spearman (nível de significância considerado α = 0,05).

Resultados: Os scores de dor (escala numérica 0-10) foram inferiores no EG, no pós-operatório imediato (-3), 24 horas (-5) e 48 horas (-4) após a cirurgia (p<0,001). As necessidades de analgesia de resgate foram inferiores no EG (p<0,001). Houve menor incidência de eventos adversos no EG, não atingindo significância estatística. O tempo de internamento na UCI foi inferior no EG (p<0,001).

Conclusão: A analgesia epidural é uma alternativa eficaz na cirurgia de escoliose pediátrica. São necessários estudos prospectivos randomizados para confirmar estes resultados.

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Publicado

2020-04-02

Como Citar

Nóbrega, S. D., Ferreira, . A. ., & Ramos, S. . (2020). Analgesia Epidural em Cirurgia de Escoliose em Idade Pediátrica. Revista Da Sociedade Portuguesa De Anestesiologia, 29(1), 12–17. https://doi.org/10.25751/rspa.19016