Abstract

BONILLA, Antonio José et al. Evaluación de la técnica anestésica con remifentanilo y midazolam en el legrado obstétrico . Rev. colomb. anestesiol. [online]. 2007, vol.35, n.3, pp.195-201. ISSN 0120-3347.

Background: Obstetric uterine curettage is a frequent procedure made in an ambulatory fashion. The ambulatory anesthesia must guarantee security, satisfaction of the patient and a fast recovery without adverse effects like nausea and vomiting or pain in the postoperative period. The use of ultrashort action opioids has not been studied as an anesthetic possibility for this type of procedures. Objectives: The following prospective study tries to evaluate the viability of a technique of intravenous analgesia with remifentanyl and anxiolysis with midazolam . Methods: This prospective case series included patients scheduled for ambulatory obstetric curettage. During the procedure midazolam was administered as an ansiolytic drug, at a dose of 0 ,03 mg/kg and during the intraoperative period ¿boluses? of remifentanyl 0,5-1 mg/kg as many as the anesthesiologist considered necessary. Dipirone , 50 mg/kg, was administered for postoperative analgesia. Patients and surgeon satisfaction was evaluated, analgesic use, hemodynamic parameters and requirement of ventilatory support, as well as incidence of nausea, vomiting and pain in the postanesthetic care unit. Results: The effectiveness of the technique was greater than 88%, satisfaction of patients and surgeons was 9.5 and 8.8, respectively, in a scale where 10 was optimal. Non relevant hemodynamic or respiratory changes appeared. Conclusion: The used technique is useful, obtaining adequate satisfaction, without mayor adverse effects. It could be applicable to other procedures of similar characteristics. This study opens a space and raises questions susceptible for later investigation, with different design and a greater number of patients.

Keywords : Intravenous analgesia; Remifentanyl; Midalozam; Obstetric curettage.

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