LUMBAR PLEXUS BLOCK BY SHAMROCK METHOD ASSOCIATED WITH SPINAL ANESTHESIA FOR HIP SURGERY: A COMPARISON WITH INTRATHECAL MORPHINE (Atena Editora)

Abstract

Justification: Postoperative pain is significant in hip surgeries and the literature is controversial. Therefore, a method of better analgesic control is sought. This research seeks to compare the analgesic action of the lumbar plexus block (BPL) with intrathecal morphine (MIT); to verify the influence of the techniques on the consumption of opioids and their side effects, and to evaluate the influence of BMI and waist circumference (CA) in the difficulty of carrying out the BPL. Method: Ensaio clínico randomizado e cego, incluindo 18 pacientes distribuídos em: Grupo Controle: MIT com 17,5mg de bupivacaína isobárica e 100mcg of morphine; Case Group: MIT with 17.5mg of bupivacaína isobárica and BPL with 20mL of 0.5% ropivacaine. The parameters of interest were evaluated at different times after anesthesia. Results: Pain scores were higher in the case group, except at 24 hours after anesthesia(p=0,039). Opioid consumption was equivalent. Nausea and vomiting were more frequent in the control group (p=0.068). Respiratory rate was similar, but SaO2 was lower in the control group at 24 hours (p=0.007). Difficulty in carrying out the BPL proved to be increasing as the IMC and CA increase. conclusions: Postoperative analgesia through lumbar plexus block by the shamrock method was not more effective than that provided by intrathecal morphine early. However, the effects of the opioid on the neuraxis were evidenced through the decrease in SaO2 in 24 hours post-anesthesia and a tendency to a higher incidence of nausea/vomiting. It was also possible to identify a direct proportion behavior between IMC and CA in relation to the difficulty of carrying out the BPL.