Epidural anesthesia with ropivacaine with or without clonidine and postoperative pain in hemorrhoidectomies¹ 1 Research performed at University Hospital Cassiano Antonio de Morais (HUCAM), Federal University of Espirito Santo (UFES), Vitoria-ES, Brazil. Part of PhD degree thesis, Postgraduate Program in Ophthalmological Surgical and Applied Sciences, Minas Gerais Federal University (UFMG). Tutor: Renato Santiago Gomez.

PURPOSE:

To determine the safety, pain intensity correlated with age and body mass index (BMI), epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy.

METHODS:

Eighty patients, both genders, 20-70 years old, ASA I or II, for hemorrhoidectomy were randomly divided into two groups: Control (n=38), epidural anesthesia with 14 mL of ropivacaine 0.75 % plus 0.0266 mL/kg of 0.9% saline solution; Experimental (n=42) epidural anesthesia with 14 mL of 0.75% ropivacaine plus 4.0 mcg/kg of clonidine. In preoperative and postoperative period were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP ), heart rate (HR ), pulse oximetry (SpO₂), electrocardiography (ECG), pain intensity (VAS ) in four, eight and, 12 hours and analgesic consumption.

RESULTS:

The VAS values differed between four, eight and 12 hours in the Experimental Group, where correlation of VAS 12h with age (p<0.05) occurred and not with BMI and more patients (p<0.05) did not receive analgesics. SBP, DBP, HR changed similarly in both groups at 15, 30 and 45 min. The ECG and SpO₂ remained unchanged.

CONCLUSIONS:

Clonidine (4mcg/kg) in epidural anesthesia with ropivacaine 0.75% in hemorrhoidectomy showed safety and greater analgesia within four hours. The pain at 12 hours showed correlation with age and not with body mass index.

Anesthesia, Epidural; Anesthetics, Local; Clonidine; Hemorrhoidectomy