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nascimento_js_dr_botfm.pdf: 722430 bytes, checksum: e2016c502b8c938e01734e5747ae7a04 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Avaliar a qualidade da sedação e os efeitos sobre a frequencia cardiaca e a pressão arterial do midazolam e do diazepam associados ou nao a clonidina, em pacientes com suspeita de doenca coronariana. Métodos: Foi desenvolvido ensaio clinico prospectivo, duplo cego, randomizado, controlado, com 160 pacientes. Estes apresentavam teste ergometrico ou cintilografia positivos para isquemia miocardica e foram submetidos a cineangiocoronariografias diagnosticas eletivas, divididos em cinco grupos de 32 pacientes cada, de acordo com o farmaco utilizado: grupo C (clonidina 0,5 Êg.kg-1); grupo M (midazolam 40 Êg.kg-1); grupo MC (associacao do midazolam 40 Êg.kg-1 e da clonidina 0,5 Êg.kg-1); grupo D (diazepam 40 Êg.kg-1); grupo DC (associacao do diazepam 40 Êg.kg-1 e da clonidina 0,5 Êg.kg-1). A sedacao foi avaliada com base na escala de Ramsay e no consumo de meperidina (0,04 mg.kg-1) que foi utilizada nos pacientes que apresentaram agitacao ou ansiedade durante o procedimento. A PA invasiva, a FC e o escore de sedacao, foram analisados a cada 5 minutos em 4 diferentes momentos: M1 - inicio do exame; M2 - 5 minutos apos o inicio do exame; M3 - metade do tempo do exame e M4 - final do exame. Resultados: Os grupos foram homogeneos com relacao a PA, FC e sedacao no momento controle (M1). Os pacientes que utilizaram o midazolam apresentaram maiores escores de sedacao e variacao da FC e PA (p<0,05). Os que utilizaram o diazepam ou a clonidina exibiram menores e mais apropriados escores de sedacao para a realizacao do exame e apresentaram menor $ variacao da PA e da FC (p>0,05). A associacao com a clonidina potencializou de forma mais precoce e acentuada os efeitos sedativos do midazolam em relacao ao diazepam (p<0,05). O consumo de meperidina nao diferiu entre os grupos estudados (p>0,10)... / Background to evaluate the effects of midazolam, diazepam and associations with clonidine on heart rate (HR), blood pressure (BP) as well as its sedative effect on patients submitted to coronary angiography. Methods A randomized, controlled and double blind, prospective clinical trial was conducted on 160 patients submitted to an elective coronary angiography. All of them have ergometric test or miocardic cintilography positive to ischemia. They were divided into five groups with 32 patients each: C group (clonidine 0,5 ìg.kg-1); M group (midazolam 40 ìg.kg-1); DC group (midazolam 40 ìg.kg-1 and clonidine 0,5 ìg/kg associated); D group (diazepam 40 ìg/kg); DC group (diazepam 40 ìg/kg and clonidine 0,5 ìg.kg-1 associated). Sedation was evaluated based on the Ramsay Scale. Administration of a 0,04 mg.kg-1 dose of meperidine was given to the patients who were agitated or anxious during the procedure. The invasive BP, HR and sedation score based on Ramsay Scale were analyzed every five minutes and four different intervals were considered for the assessment: M1- at the start of the test; M2 5 minutes after the start of the test; M3 half time of the test; M4 at the end of the test. Results The groups were homogeneous in relation the BP, HR and sedation in the control moment (M1) and there was no difference regarding the weight, age and sex. The patients that used midazolam presented deeper sedation score and HR and BP variability (p<0,05). The patients that used diazepam or clonidine have superficial sedation score and better BP and HR stability. The association with clonidine showed the midazolam sedative effects earlier and $ deeper than diazepam (p<0,05). There was no difference in meperidine use (p>0,10) Conclusions The midazolam presented higher and deeper sedative and cardiovascular effect... (Complete abstract, click eletronic address below)
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unesp.br:11449/106013 |
| Date | 27 February 2007 |
| Creators | Nascimento, Jedson dos Santos [UNESP] |
| Contributors | Universidade Estadual Paulista (UNESP), Módolo, Norma Sueli Pinheiro [UNESP] |
| Publisher | Universidade Estadual Paulista (UNESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 139 f. |
| Source | Aleph, reponame:Repositório Institucional da UNESP, instname:Universidade Estadual Paulista, instacron:UNESP |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -1, -1 |
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