ANALGESIA PERIDURAL CONTÍNUA: ALGUMAS REFLEXÕES SOBRE OS SEUS EFEITOS ADVERSOS
DOI:
https://doi.org/10.36557/2674-8169.2024v6n11p1767-1782Keywords:
Continuous epidural analgesia, Efficacy, Adverse effects, Risk factors.Abstract
Continuous epidural analgesia is effective in pain control, providing prolonged relief and enhancing patients’ quality of life. However, it is crucial to monitor adverse effects, such as hypotension and urinary retention, as well as associated risk factors like catheter-related complications and improper technique. Careful management of these aspects is essential to balance the benefits of continuous epidural analgesia with patient safety and comfort. The objective of this systematic review is to analyze the efficacy of continuous epidural analgesia, identify its adverse effects, and evaluate the associated risk factors to improve clinical practice and pain management The scientific databases Scopus and PubMed were used for article selection, with the following English keywords: “Continuous epidural analgesia, Efficacy, Adverse effects, Risk factors.”. Continuous epidural analgesia is widely recognized for its effectiveness in pain management, providing significant advantages in terms of pain control compared to other modalities. Its efficacy is well-documented, offering prolonged relief and improving patients’ quality of life. However, associated adverse effects, such as hypotension and urinary retention, and risk factors involved, such as improper technique and catheter-related complications, must be carefully monitored to minimize negative impacts. Balancing benefits and risks is essential to optimizing pain management with continuous epidural analgesia and ensuring patient safety and comfort.
Downloads
References
LEE, B.; LEE, J. H.; KIM, M. S.; KIM, S. J.; SONG, J.; KIM, D. H.; CHOI, Y. S. Epidural bolus versus continuous epidural infusion analgesia on optic nerve sheath diameter in paediatric patients: A prospective, double-blind, randomised trial. Sci Rep, v. 10, n. 1, p. 5477, 2020. doi: 10.1038/s41598-020-62273-8. PMID: 32214139; PMCID: PMC7096447. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096447/. Acesso em: 27 ago. 2024.
LAI, J.; SITU, D.; XIE, M.; YU, P.; WANG, J.; LONG, H.; LAI, R. Continuous Paravertebral Analgesia versus Continuous Epidural Analgesia after Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: A Randomized Controlled Trial. Ann Thorac Cardiovasc Surg, v. 27, n. 5, p. 297-303, 2021. doi: 10.5761/atcs.oa.20-00283. PMID: 33597333; PMCID: PMC8560537. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560537/. Acesso em: 27 ago. 2024.
TZENG, I. S.; KAO, M. C.; PAN, P. T.; CHEN, C. T.; LIN, H. Y.; HSIEH, P. C.; KUO, C. Y.; HSIEH, T. H.; KUNG, W. M.; CHENG, C. H.; CHEN, K. H. A Meta-Analysis of Comparing Intermittent Epidural Boluses and Continuous Epidural Infusion for Labor Analgesia. Int J Environ Res Public Health, v. 17, n. 19, p. 7082, 2020. doi: 10.3390/ijerph17197082. PMID: 32992642; PMCID: PMC7579642. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579642/. Acesso em: 27 ago. 2024.
LIU, X.; ZHANG, H.; ZHANG, H.; GUO, M.; GAO, Y.; DU, C. Intermittent epidural bolus versus continuous epidural infusions for labor analgesia: A meta-analysis of randomized controlled trials. PLoS One, v. 15, n. 6, p. e0234353, 2020. doi: 10.1371/journal.pone.0234353. PMID: 32530935; PMCID: PMC7292420. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292420/. Acesso em: 27 ago. 2024.
FIDKOWSKI, C. W.; SHAH, S.; ALSADEN, M. R. Programmed intermittent epidural bolus as compared to continuous epidural infusion for the maintenance of labor analgesia: a prospective randomized single-blinded controlled trial. Korean J Anesthesiol, v. 72, n. 5, p. 472-478, 2019. doi: 10.4097/kja.19156. PMID: 31216846; PMCID: PMC6781207. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781207/. Acesso em: 27 ago. 2024.
HUANG, R.; ZHU, J.; ZHAO, Z.; WANG, B. The effect of programmed intermittent epidural bolus compared with continuous epidural infusion in labor analgesia with ropivacaine: a meta-analysis of randomized controlled trials. Ann Palliat Med, v. 10, n. 3, p. 2408-2420, 2021. doi: 10.21037/apm-20-1541. PMID: 33549010. Disponível em: https://apm.amegroups.org/article/view/61995/html. Acesso em: 27 ago. 2024.
LI, X. L.; ZHANG, J.; WAN, L.; WANG, J. Efficacy of Single-shot Thoracic Paravertebral Block Combined with Intravenous Analgesia Versus Continuous Thoracic Epidural Analgesia for Chronic Pain After Thoracotomy. Pain Physician, v. 24, n. 6, p. E753-E759, 2021. PMID: 34554693. Disponível em: https://www.painphysicianjournal.com/linkout?issn=&vol=24&page=E753. Acesso em: 27 ago. 2024.
SATO, I.; IWASAKI, H.; LUTHE, S. K.; IIDA, T.; KANDA, H. Comparison of intrathecal morphine with continuous patient-controlled epidural anesthesia versus intrathecal morphine alone for post-cesarean section analgesia: a randomized controlled trial. BMC Anesthesiol, v. 20, n. 1, p. 138, 2020. doi: 10.1186/s12871-020-01050-6. PMID: 32493372; PMCID: PMC7268233. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268233/. Acesso em: 27 ago. 2024.
LIU, X.; OU, C.; PENG, F.; MU, G. Comparison of analgesic efficacy of continuous transversus abdominis plane block with continuous epidural analgesia in patients undergoing abdominal surgery: a systematic review and meta-analysis. J Int Med Res, v. 48, n. 6, p. 300060520922691, 2020. doi: 10.1177/0300060520922691. PMID: 32485123; PMCID: PMC7273870. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273870/. Acesso em: 27 ago. 2024.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Warllon de Souza Barcellos, Mither Bissoli de Oliveira, Lucca Luigi Di Bucaneve Morassutti, Eduarda Zimmermann Ribas, Giovana Von Dokonal Ferreira, Carlos Eduardo La Cava Pinto Da Silva, Carolina Gato Trento, Giovana Georgetti Fernandes, Yan Cosendey Ferreira, João Filipe Cardozo de Barros, João Victor Santos Pessanha, Leonardo Enrique Ues Cury, Bernardo Campos Vellasco, Giovanna Machado Barbosa Costa, Joaquim Sátiro de Mendonça Neto, Gabriel Felipe da Silva Guerra, Olavo Martins da Silva de Rezende, Keliane Almeida Neres, Felipe Gomes Sant’Ana, Juliana Vasconcellos Amorim Salomão

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.



