Influência da morfina peridural na função pulmonar de pacientes submetidos à colecistectomia aberta
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Data
2007
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Resumo
BACKGROUND AND OBJECTIVES: Upper abdominal surgeries
may cause postoperative respiratory dysfunction. The objective of
this study was to evaluate the pulmonary function after laparoscopic
and open cholecystectomies, with and without epidural morphine.
METHODS: In this randomized, double-blind clinical trial, 45 pa-
tients undergoing cholecystectomies were divided in three groups:
GL, GA, and GAM, composed of 15 patients each. The GL group
underwent laparoscopic surgery, while GA and GAM underwent open
cholecystectomy, but the former received epidural morphine. Pre-
and postoperative spirometry and arterial blood gases were
performed. ANOVA was used to verify the hypothesis of equality of
the means among the groups. When results were statistically sig-
nificant, the Tukey test was performed. Paired test t Student was
used to verify the hypothesis of equality within a group. A p < 0.05
was considered significant.
RESULTS: The pre and immediately postoperative spirometry
results were used to determine: a) forced vital capacity (FVC) in GL
versus GA (p = 0.000) and GL versus GAM (p = 0.000); percentage
of the reduction of FVC in GA versus GAM (p = 0.001); b) within
each group: in GL, FVC (p = 0.020) and forced expiratory volume
in 1 second (FEV 1 ) (p = 0.022); in GA, FVC (p < 0.001) and FEV 1
(p < 0.001); and in GAM, FVC (p = 0.007) and FEV 1 (p = 0.001). The
arterial oxygen pressure (PaO 2 ) was reduced in all three groups.
CONCLUSIONS: One can conclude that respiratory dysfunction was
less severe in patients operated by laparoscopy and that epidural
morphine reversed, partially, the postoperative ventilatory
disturbances of open cholecystectomy.
Descrição
Palavras-chave
Analgesia, Pós-operatória, Morfina peridural, Cirurgia, Abdominal, Disfunção diafragmática, Colecistectomia aberta, Colecistectomia videolaparoscópica, Complicações, Atelectasia, Pós-operatória
Citação
RAMOS, Gilson Cassem et al. Influência da morfina peridural na função pulmonar de pacientes submetidos à colecistectomia aberta. Revista Brasileira de Anestesiologia, Rio de Janeiro, v. 57, n. 4, p. 366-381, 2007.