Estudo da dor no período pós-operatório de cirurgia de catarata: utilização de dipirona no intraoperatório / Study on immediate postoperative pain following cataract surgery: intraoperative endovenous administration of dipyrone

Resumo Objetivos: Quantificar a dor dos pacientes submetidos a cirurgia de facoemulsificação sob anestesia tópica e anestesia tópica mais dipirona e avaliar se há correlação da dor com o tempo operatório, a graduação da catarta e a Energia Ultrassônica Dissipada Acumulada. Métodos: Cento e quatro olhos de 52 pacientes foram submetidos a cirurgia de catarata por facoemulsificação. Um olho foi submetido a anestesia tópica associado à sedação. O outro olho foi submetido a anestesia anterior acrescida de 1g de dipirona venosa. 15 minutos e 24 horas após a cirurgia, uma Escala Visual de Dor era respondida. Registraram-se a graduação da catarata, tempo cirúrgico, energia ultrassônica. Resultados: Dor no grupo sem dipirona 15 minutos e 24 horas apresentou decréscimo com correlação estatística significativa (p=0,004). Não houve significância estatística na redução da dor no grupo submetido à infusão de dipirona. Pacientes com cataratas de maior graduação apresentaram dor maior no pós-operatório (p=0,046). Conclusão: Ausência de redução significativa da dor com a dipirona apresentou resultados semelhantes a outros estudos. Redução da dor 24 horas após a cirurgia no grupo sem o analgésico pode ser devido à subjetividade da dor. Pacientes com cataratas de grau mais avançados apresentam dor mais intensa.

Abstract Objectives: Evaluate the effect of intraoperative endovenous administration of dipyrone on postoperative pain in patients submitted to phacoemulsification by correlating pain scores with duration of surgery and the amount of cumulative dissipated energy (CDE) delivered to the eye. Methods: The sample consisted of 104 eyes from 52 patients submitted to phacoemulsification under topic anesthesia and sedation. In each patient, one eye was treated intraoperatively with 1g dipyrone. Information was collected on cataract grade/type, duration of surgery and CDE. Postoperative pain was scored on a visual analog scale at 15 min and 24 hours. Results: Between 15 min and 24 hours, pain decreased significantly (p=0.004) among patients not treated with dipyrone, but no change was observed in patients receiving dipyrone. Caratact severity was positively associated with postoperative pain (p=0.046). Conclusion: The absence of a measurable effect of dipyrone on pain scores matched the literature. The decrease in pain scores at 24 hours among patients not treated with dipyrone may be explained by the influence of subjective psychological factors on pain perception. Higher grades of cataract were associated with greater postoperative pain.

Analysis of liver fragment subjected to autologous transplant at rat's retroperitoneum.

BACKGROUND: To investigate the regeneration process of autologous implants of liver on the retroperitoneum. METHODS: Thirty male Fisher rats were used divided in to group 1 (G1): studied 60 d after surgery; group 2 (G2): studied 90 d after surgery; group 3 (G3): studied 180 d after surgery; and group C (GC): animals without surgery. Hepatic fragment was processed for histologic and biochemical analysis. RESULTS: There was inflammatory infiltrate, diffuse hydropic degeneration, necrosis, and moderate fibrosis that reduced in direct relation to the postsurgical time. The concentration of albumin was different between GC and G1 and between G1 and G3 (P = 0.0007). The Catalase (CAT) was related to the time of surgery with GC being different when compared with G1, G2, and G3 (P < 0.0001). The oxidative stress measured through the thiobarbituric acid reactive substances lipid peroxidation was different between the GC and the G2 groups (P = 0.0381). CONCLUSIONS: The analysis made showed hepatic regeneration in the fragment subjected to autologous transplant at the retroperitoneum.