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Revista Cubana de Anestesiología y Reanimación

2014, Number 2

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Revista Cubana de Anestesiología y Reanimación 2014; 13 (2)

Epidural opioids associated with bupivacaine for postoperative analgesia in preeclamptic pregnant women undergoing cesarean delivery

Seguras LO, Echevarría HAT, Hernández LLF, Fitó FK

Language: Spanish
References: 18
Page: 105-114
PDF size: 136.39 Kb.


ABSTRACT

Introduction: The combination of opioids and epidural local anesthetics has been used to treat postoperative pain in women undergoing cesarean delivery. However, the combination has not been widely studied or used in preeclamptic pregnant women.
Objective: Determine the efficacy of the association of opioids with bupivacaine for epidural anesthesia as a strategy to control postoperative pain in preeclamptic patients undergoing cesarean delivery.
Method: An analytical prospective longitudinal study was conducted during the 2008-2011 period of 56 preeclamptic pregnant women undergoing cesarean delivery under epidural anesthesia at Dr. Luis Díaz Soto hospital, who were randomly distributed in two groups according to the opioid added to bupivacaine: Group T (bupivacaine + tramadol) and Group F (bupivacaine + fentanyl). The evaluation conducted during the perioperative period included hemodynamic and respiratory variables, adverse effects and quality of postoperative analgesia in the first six hours. Results were processed with a reliability level of 95%.
Results: Intraoperative nausea and vomiting were more common in Group T (p › 0.05), whereas somnolence and pruritus predominated in Group F (p=0.000). No neonatal repercussions were observed. Most patients (73.21%) remained stable during the postoperative period. The following cardiovascular complications were found: hypertension (19.6%), hypotension (19.6 %), tachycardia (14.3%), bradycardia (14.3%), and to a lesser degree premature supraventricular and ventricular contractions. Analgesia was evaluated as satisfactory in both groups (p › 0.05).
Conclusions: The association of bupivacaine with epidural tramadol or fentanyl is effective to treat immediate postoperative pain in preeclamptic pregnant women undergoing cesarean delivery.


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