Participants and Interventions
When the patient arrives in the operating room, he signs the term of adherence to the work protocol and is monitored immediately afterward. He then receives anxiolytic medication (midazolam) until tranquilization. Minutes later, the client sits down for epidural puncture, in T9/T10 to T12/L1 in upper floor surgeries (pancreatectomy, nephrectomy, aortic aneurysm, thoracotomy, and hepatectomy, or L3/L4, L2/L3 for lower floor surgeries of the abdomen (cystectomy, rectosigmoidectomy, prostatectomy. The epidural solution to be administered:
- Clonidine 3ug/kg
- Sufentanil 30ug
- Morphine 30ug/Kg
- Thus, the proportion is 3/30/30.
The patient then lies down to start general anesthesia with Propofol at a dose up to Bis around 40 and atracurium at a dose of 0.5 to 0.6 mg/kg.
Intubation was performed and anesthesia complementation with Sevorane, aiming Bis around 50 as a target.
Measurements of pressure, heart rate, bis, Sat O2, expired CO2, inspired and expired sevorane; will be collected before intubation, Post intubation, and surgery sequence until after extubation, as well as any complications.
Furthermore, data on pain after surgery completion and extubation, intraoperative hydration, blood loss, and diuresis during surgery will be recorded.
- Intraoperative:
Sufentanil 10ug plus what was left of clonidine to complete 300ug.
- Postoperative:
Complete the 50 ug/Kg of morphine.
All rescues via epidural catheter
Observation: Intraoperatively, when analgesic rescue was needed, the prescribed solution was defined with 10 µg of sufentanil and 100 µg of clonidine diluted with 0.9% saline solution in 10 mL; applied via epidural twice if necessary. In the immediate postoperative period, if necessary, the application of analgesic rescue for moderate to severe pain; epidural morphine up to 50ug/kg.