Levobupivacaína para el tratamiento de dolor postoperatorio en la circuncisión: bloqueo caudal o dorsal del pene
Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block.
Kazak Bengisun Z, Ekmekci P, Haliloğlu AH.
Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey. kazakzuleyha@yahoo.com
Agri. 2012 Oct;24(4):180-6. doi: 10.5505/agri.2012.21931.
Abstract
OBJECTIVES: In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients. METHODS: Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded. RESULTS: Demographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours. CONCLUSION: Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.
http://www.journalagent.com/pubmed/linkout.asp?ISSN=1300-0012&PMID=23364781
Características clínicas de levobupivacaína espinal: hiperbárica comparada con solución isobárica
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive 3 ml of either isobaric or hyperbaric 0.42% levobupivacaine intrathecally We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block.
Kazak Bengisun Z, Ekmekci P, Haliloğlu AH.
Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey. kazakzuleyha@yahoo.com
Agri. 2012 Oct;24(4):180-6. doi: 10.5505/agri.2012.21931.
Abstract
OBJECTIVES: In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients. METHODS: Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded. RESULTS: Demographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours. CONCLUSION: Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.
http://www.journalagent.com/pubmed/linkout.asp?ISSN=1300-0012&PMID=23364781
Características clínicas de levobupivacaína espinal: hiperbárica comparada con solución isobárica
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive 3 ml of either isobaric or hyperbaric 0.42% levobupivacaine intrathecally We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
No hay comentarios:
Publicar un comentario