SciELO - Scientific Electronic Library Online

vol.55 issue1Analgesic efficacy of dexmedetomidine as compared to sufentanil in intraperitoneal surgeries: comparative studyComparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094On-line version ISSN 1806-907X


CASTRO, Ferdinand Edson de  and  GARCIA, João Batista Santos. Preemptive analgesia with epidural bupivacaine and S(+)ketamine in abdominal hysterectomy. Rev. Bras. Anestesiol. [online]. 2005, vol.55, n.1, pp.28-39. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: This study investigates the ability of epidural S(+)ketamine, NMDA receptor antagonist, plus local anesthetic (bupivacaine) injection to promote preemptive analgesia in patients undergoing total abdominal hysterectomy, when this solution is administered before surgical incision. METHODS: Participated in this prospective double-blind study 30 patients were randomly assigned in two equal groups. Epidural injection and catheter insertion were performed at L1-L2 interspace. Group 1 (G1) patients received 17 mL bupivacaine 0.25% plus 3 mL S(+)ketamine (30 mg), 30 min before surgical incision, followed by 20 mL saline 30 min after incision. Group 2 (G2) patients received 20 mL saline 30 min before surgical incision, followed by 17 mL bupivacaine 0.25% plus 3 mL S(+)ketamine (30 mg) 30 min after incision. General anesthesia was induced with propofol, pancuronium, O2 and isoflurane. Postoperative analgesia consisted of epidural fentanyl plus bupivacaine bolus with 4h minimal interval. If necessary, IV dipyrone supplementation was administered. Patients were evaluated for analgesia by a verbal and numeric scale (at recovery and every six hours until 24 postoperative hours). Time to first analgesic request and total analgesic requirements were recorded. RESULTS: There were no significant differences between groups in time to first analgesic request, total analgesic consumption and numeric or verbal scale pain scores. CONCLUSIONS: This study failed to demonstrate a preemptive effect of epidural administration of bupivacaine and S(+)ketamine in the doses tested for abdominal hysterectomy.

Keywords : ANALGESIA [epidural]; ANALGESIA [preemptive]; ANESTHETICS [bupivacaine]; ANESTHETICS [ketamine].

        · abstract in Portuguese | Spanish     · text in English | Portuguese     · English ( pdf epdf ) | Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License