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Revista Brasileira de Anestesiologia
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Revista Brasileira de Anestesiologia
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Revista Brasileira de Anestesiologia
Article . 2015
License: CC BY NC ND
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Aplicação clínica do bloqueio anestésico paravertebral torácico em operações de mama

Authors: Sara Socorro Faria; Renato Santiago Gomez;

Aplicação clínica do bloqueio anestésico paravertebral torácico em operações de mama

Abstract

ResumoIntroduçãoo adequado tratamento da dor pós‐operatória tem sido de fundamental importância nos cuidados com o paciente cirúrgico. Entre as técnicas de analgesia direcionadas para esse grupo de pacientes, o bloqueio paravertebral torácico combinado com a anestesia geral se destaca pelos bons resultados e pela favorável relação risco‐benefício. Muitos anestésicos locais e outros fármacos adjuvantes vêm sendo investigados para uso nessa técnica, com vistas a melhorar a qualidade da analgesia e reduzir os efeitos adversos.Objetivoavaliar a eficácia e a segurança do bloqueio paravertebral em comparação com outros regimes analgésicos e anestésicos em mulheres submetidas a cirurgias para câncer de mama.Métodosrevisão integrativa da literatura de 1966 a 2012, feita por meio de termos específicos nos bancos de dados informatizados, de artigos que investigaram as características clínicas e os efeitos adversos e benéficos do bloqueio paravertebral torácico.Resultadosno período selecionado, foram identificados 16 estudos randomizados que preenchiam os critérios de seleção estabelecidos para essa revisão bibliográfica. O bloqueio paravertebral torácico demonstrou uma redução significativa da dor pós‐operatória, bem como diminuição da dor durante movimentos do braço após a cirurgia.Conclusãoo bloqueio paravertebral torácico reduziu a necessidade pós‐operatória de analgésicos quando comparado ao grupo placebo, notadamente dentro das primeiras 24 horas. O emprego dessa técnica poderia garantir uma analgesia pós‐cirúrgica de relevância clínica. Novos estudos, com maiores grupos populacionais, fazem‐se necessários, uma vez que o bloqueio paravertebral parece promissor em analgesia preemptiva para cirurgia de câncer de mama.AbstractIntroductionoptimum treatment for postoperative pain has been of fundamental importance in surgical patient care. Among the analgesic techniques aimed at this group of patients, thoracic paravertebral block combined with general anesthesia stands out for the good results and favorable risk‐benefit ratio. Many local anesthetics and other adjuvant drugs are being investigated for use in this technique, in order to improve the quality of analgesia and reduce adverse effects.Objectiveevaluate the effectiveness and safety of paravertebral block compared to other analgesic and anesthetic regimens in women undergoing breast cancer surgeries.Methodsintegrative literature review from 1966 to 2012, using specific terms in computerized databases of articles investigating the clinical characteristics, adverse effects, and beneficial effects of thoracic paravertebral block.Resultson the selected date, 16 randomized studies that met the selection criteria established for this literature review were identified. Thoracic paravertebral block showed a significant reduction of post‐operative pain, as well as decreased pain during arm movement after surgery.Conclusionthoracic paravertebral block reduced postoperative analgesic requirement compared to placebo group, markedly within the first 24hours. The use of this technique could ensure postoperative analgesia of clinical relevance. Further studies with larger populations are necessary, as paravertebral block seems to be promising for preemptive analgesia in breast cancer surgery.

Keywords

Postoperative complications, Paravertebral block, Breast cancer, Anesthesiology and Pain Medicine, Bloqueio paravertebral, Câncer de mama, Complicações pós‐operatórias

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
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