Ropivacaína em bloqueio peridural torácico para cirurgia plástica

Abstract

Justificativa e Objetivos

Anestesia no paciente com síndrome do pulmão encolhido: relato de caso

“…The decision on the choice of anesthesia is influenced by the surgical time and field, in addition to the patient's clinical conditions. The effects of epidural anesthesia on pulmonary function seem to be beneficial 8,9 . Both local anesthetics and opioids help diaphragmatic function, improving lung volume and capacity and reducing postoperative complications 9,10 .…”

“…The effects of epidural anesthesia on pulmonary function seem to be beneficial 8,9 . Both local anesthetics and opioids help diaphragmatic function, improving lung volume and capacity and reducing postoperative complications 9,10 . If the spread of local anesthetic reaches the cervical roots (C5 to C3), respiratory function may be compromised by blocking intercostal nerves and the partial or total blockage of the phrenic nerve.…”

“…Ropivacaine is a local anesthetic belonging to the pipecoloxylidide group, noted by the lower intensity of motor block and reduced potential for cardiovascular toxicity compared to bupivacaine 8,9 . It is known that the thoracic epidural block with concentrated solutions of bupivacaine causes a moderate reduction in vital capacity and in maximal inspiratory flow, probably due to a certain degree of relaxation of the intercostal muscles 8,9 . The use of less concentrated solutions of a local anesthetic such as ropivacaine may reduce the possibility of significant impairment of respiratory muscles 9 .…”

Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos

“…Como as cirurgias na coluna vertebral foram realizadas nos segmentos lombares (L 4 -L 5 e L 5 -S 1 ), não havia contra-indicação à punção peridural torácica proposta para a paciente. A realização de anestesia peridural torácica em nosso serviço se faz baseada nas vantagens da técnica 36,37 . Atécnica pode ser utilizada c o m o a n e s t e s i a ( c i r u r g i a s p l á s t i c a s ) , a n a l g e s i a pós-operatória (toracotomias), dentre outras indicações.…”

“…Since spinal surgeries were performed in lumbar segments (L 4 -L 5 and L 5 -S 1 ), there was no counterindication for thoracic epidural puncture proposed for the patient. Thoracic epidural anesthesia in our service is based on the advantages of this technique 36,37 . It may be used for anesthesia (plastic surgeries) or for postoperative analgesia (thoracotomies), among other indications.…”