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• W2493950003 abstract "Há evidências de que a administração de um bolus epidural intermitente programado (BEIP) comparada com a infusão epidural contínua (IEC) resulta em maior eficácia da analgesia e da satisfação materna, com redução das intervenções anestésicas. Neste estudo, 166 mulheres com gravidezes viáveis foram incluídas. Após uma dose epidural de 10 mL de ropivacaína a 0,16% e adição de 10 μg de sufentanil, as parturientes foram aleatoriamente designadas para um dos três regimes: A ‐ ropivacaína a 0,15% mais solução de sufentanil (0,2 μg/mL) como infusão peridural contínua (5 mL/h, imediatamente após o bolus inicial); B ‐ ropivacaína a 0,1% mais sufentanil (0,2 μg/mL) como bolus epidural intermitente programado; C ‐ solução idêntica à do Grupo A com bolus epidural intermitente programado. Os regimes BEIP foram programados como 10 mL por hora, começaram 60 minutos após o bolus inicial. Bolus de resgate de 5 mL da mesma solução foi administrado com bomba de infusão. A satisfação materna foi avaliada com uma escala numérica verbal de 0 a 10. Também avaliamos os resultados adversos maternais e neonatais. Foram avaliadas 130 gestantes (A = 60, B = 33; C = 37). A mediana na escala numérica verbal para a satisfação materna foi de 8,8 no grupo A; 8,6 no grupo B e 8,6 no grupo C (p = 0,83). Encontramos uma taxa mais elevada para parto cesário no grupo A (56,7%; p = 0,02). Não observamos diferenças no bloqueio motor, taxa de parto instrumental e resultados neonatais. A manutenção da analgesia peridural com bolus epidural intermitente programado está associada a uma redução da incidência de parto cesariano com satisfação materna igualmente elevada e sem resultados adversos. There is evidence that administration of a programmed intermittent epidural bolus (PIEB) compared to continuous epidural infusion (CEI) leads to greater analgesia efficacy and maternal satisfaction with decreased anesthetic interventions. In this study, 166 women with viable pregnancies were included. After an epidural loading dose of 10 mL with Ropivacaine 0.16% plus Sufentanil 10 μg, parturient were randomly assigned to one of three regimens: A – Ropivacaine 0.15% plus Sufentanil 0.2 μg/mL solution as continuous epidural infusion (5 mL/h, beginning immediately after the initial bolus); B – Ropivacaine 0.1% plus Sufentanil 0.2 μg/mL as programmed intermittent epidural bolus and C – Same solution as group A as programmed intermittent epidural bolus. PIEB regimens were programmed as 10 mL/h starting 60 min after the initial bolus. Rescue boluses of 5 mL of the same solution were administered, with the infusion pump. We evaluated maternal satisfaction using a verbal numeric scale from 0 to 10. We also evaluated adverse, maternal and neonatal outcomes. We analyzed 130 pregnants (A = 60; B = 33; C = 37). The median verbal numeric scale for maternal satisfaction was 8.8 in group A; 8.6 in group B and 8.6 in group C (p = 0.83). We found a higher caesarean delivery rate in group A (56.7%; p = 0.02). No differences in motor block, instrumental delivery rate and neonatal outcomes were observed. Maintenance of epidural analgesia with programmed intermittent epidural bolus is associated with a reduced incidence of caesarean delivery with equally high maternal satisfaction and no adverse outcomes." @default.
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• W2493950003 date "2016-09-01" @default.
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• W2493950003 title "Estudo prospectivo, randômico, controlado e de avaliação cega do desfecho – infusão peridural contínua versus bolus epidural intermitente programado em analgesia de parto" @default.
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• W2493950003 doi "https://doi.org/10.1016/j.bjan.2015.10.003" @default.
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