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Epidural anesthesia with ropivacaine with or without clonidine and postoperative pain in hemorrhoidectomies
João Florêncio de Abreu Baptista1, Renato Santiago Gomez2, Danilo Nagib Salomão Paulo3
1Espirito Santo Federal University, Department of Surgical Clinic, VitoriaES, Brazil, Master, Fellow PhD degree, Postgraduate Program in Ophthalmological Surgical and Applied Sciences, Minas Gerais Federal University (UFMG). Associate professor, Division of Anesthesiology, Department of Surgical Clinic, Espirito Santo Federal University (UFES), Vitoria-ES, Brazil. Conception, design and scientific content of the study.
Purpose:
To determine the safety, pain intensity correlated with age and body mass index (BMI), epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy.
Methods:
Eighty patients, both genders, 20-70 years old, ASA I or II, for hemorrhoidectomy were randomly divided into two groups: Control (n=38), epidural anesthesia with 14 mL of ropivacaine 0.75 % plus 0.0266 mL/kg of 0.9% saline solution; Experimental (n=42) epidural anesthesia with 14 mL of 0.75% ropivacaine plus 4.0 mcg/kg of clonidine. In preoperative and postoperative period were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP ), heart rate (HR ), pulse oximetry (SpO2), electrocardiography (ECG), pain intensity (VAS ) in four, eight and, 12 hours and analgesic consumption.
Results:
The VAS values differed between four, eight and 12 hours in the Experimental Group, where correlation of VAS 12h with age (p<0.05) occurred and not with BMI and more patients (p<0.05) did not receive analgesics. SBP, DBP, HR changed similarly in both groups at 15, 30 and 45 min. The ECG and SpO2 remained unchanged.
Conclusions:
Clonidine (4mcg/kg) in epidural anesthesia with ropivacaine 0.75% in hemorrhoidectomy showed safety and greater analgesia within four hours. The pain at 12 hours showed correlation with age and not with body mass index.
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