the visualization of the facet joint by ultrasound involves minimal risk, besides reduction of radiation. This option is suitable for a large part of the population. However, fluoroscopy and computed tomography remain as monitoring techniques indicated for patients with specific characteristics, such as obesity, severe degenerative diseases and anatomical malformations, in which the ultrasound technique is still in need of further study.
The visualization of the facet joint by ultrasound involves minimal risk, besides reduction of radiation. This option is suitable for a large part of the population. However, fluoroscopy and computed tomography remain as monitoring techniques indicated for patients with specific characteristics, such as obesity, severe degenerative diseases and anatomical malformations, in which the ultrasound technique is still in need of further study.
Objectives. The aim of this study was to assess the effects of clonidine on intraoperative analgesia, sedation, intraocular and blood pressure, arrhythmia, and ischemia.
Methods. Forty patients undergoing cataract surgery were allocated into two groups. They were monitored with Holter machine, the pupil was dilated, and 30 minutes later, 20 patients received clonidine (4 µg/kg), while the other 20 patients were given a 0.9% saline intravenously. Twenty minutes later, 2% lidocaine gel was applied. There were assessed intraoperative analgesia, intraocular pressure, blood pressure, heart rate, and the occurrence of arrhythmias and myocardial ischemia. Results. Pain intensity was lower in G1 during the phacoemulsification, irrigation, aspiration, and intraocular lens implantation. The HR and BP were lower with clonidine. The IOP was lower with clonidine after 15 minutes and at the end of the surgery. Sedation was higher with clonidine. The incidence of arrhythmia was lower at the end of surgery with clonidine. The incidence of myocardial ischemia did not differ between the groups. Conclusions. Clonidine (4 µg/kg) before a phacoemulsification reduced the intensity of pain during cataract surgery. It also induced sedation, reduction of BP, HR, and incidence of arrhythmia at the end of the surgery, and did not alter myocardial ischemia. This trial is registered with Clinicaltrials.gov NCT01677351.
BackgroundPregabalin is an anticonvulsant and has been used for postoperative analgesia. This study aimed to assess the effect of a single preoperative dose of pregabalin for analgesia after nephrectomy.MethodsThe study was prospective, randomized, comparative, and double-blinded, conducted in 40 kidney transplant donors, between 18 and 60 years, American Society of Anesthesia physical status I or II. Epidural anesthesia was performed with 15 mL of 0.5% ropivacaine single shot and general anesthesia with 3 µg/kg of fentanyl, propofol, atracurium, and sevoflurane, and 50% of oxygen without nitrous oxide. Patients in group 1 were administered 300 mg of pregabalin and those in group 2 were administered placebo, in identical capsules, 1 hour prior to surgery. Postoperative analgesia was supplemented with tramadol. The following parameters were assessed: pain intensity after 6 and 24 hours; pain threshold, from the thenar and peri-incisional region, analgesic supplementation; ILs (IL6, IL8, and IL10) prior to surgery and after 6 and 24 hours.ResultsThe pain intensity was lower with pregabalin after 24 hours (G1: 2.5±2.4, G2: 3.0±2.6). There was no difference in the sensitivity of the thenar and peri-incisional region after 6 and 24 hours; in the number of patients requiring supplementation (G1=15%, G2=45%); concentrations of IL-6, IL-8, and IL-10; and side effects (nausea, vomiting, dizziness, and pruritus).ConclusionPregabalin in a single preoperative dose of 300 mg reduced pain intensity 24 hours after lumbotomy.
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