{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:04:28Z","timestamp":1753887868800,"version":"3.41.2"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"abstract":"<jats:p>ABSTRACT   Background:  As the number of bariatric operations increases, there is a greater interest in knowledge, experience and skills in the operative and anesthetic management of obese people. Anesthetic recovery is an important point in the therapeutic approach and less adverse effects delaying discharge of these patients are necessary to be kept in mind by the surgical team.   Aim:  To compare anesthetic-analgesic techniques in the opioid-sparing era through epidural administration of local anesthetic associated with low-dose morphine vs. clonidine and analyze the impact of analgesia on the effectiveness of postoperative recovery by comparing these two techniques.   Methods: Randomized, double-blind clinical trial with 66 patients candidates for Roux-en-Y gastrojejunal bypass divided into two groups: morphine group and clonidine group. Multimodal analgesia included epidural anesthesia with 0.375% ropivacaine 20 ml at the eighth thoracic vertebra with the association of morphine (morphine group) at a dose of 15 mcg \/ kg or clonidine (clonidine group) at a dose of 1 mcg \/ kg.   Results:  The groups were homogeneous and statistical significance was found when analyzing the difference in pain between them in the first postoperative period. The pain was higher in the clonidine group, as in this period, analgesic rescue was also better in this group. In the other times, there was no significance in the differences regarding pain and rescue. The return of intestinal motility in the morphine group was earlier in the first postoperative period. Nausea, vomiting and hospital discharge did not show significant differences between groups.   Conclusion:  Epidural anesthesia with low-dose morphine allowed less pain during the entire hospital stay, with a positive impact on patient recovery.<\/jats:p>","DOI":"10.1590\/0102-672020200002e1530","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T17:57:40Z","timestamp":1621015060000},"source":"Crossref","is-referenced-by-count":3,"title":["ROUX-IN-Y GASTROJEJUNAL BYPASS: WHICH ANESTHETIC TECHNIQUE HAS BEST RESULTS?"],"prefix":"10.1590","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7426-7133","authenticated-orcid":false,"given":"Arthur","family":"RUZZON","sequence":"first","affiliation":[{"name":"Mackenzie Evangelical College of Paran\u00e1,  Brazil; Rocio Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1752-5837","authenticated-orcid":false,"given":"Paulo Afonso Nunes","family":"NASSIF","sequence":"additional","affiliation":[{"name":"Mackenzie Evangelical College of Paran\u00e1,  Brazil; Rocio Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1729-8419","authenticated-orcid":false,"given":"Lais","family":"PRIGOL","sequence":"additional","affiliation":[{"name":"Rocio Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6133-3701","authenticated-orcid":false,"given":"Lucas","family":"BUZO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4074-9521","authenticated-orcid":false,"given":"Guilherme","family":"WENDLER","sequence":"additional","affiliation":[{"name":"Rocio Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-6169","authenticated-orcid":false,"given":"Eduardo","family":"WENDLER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3737-8395","authenticated-orcid":false,"given":"Ilana Barrichello Torres","family":"WENDLER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5790-9341","authenticated-orcid":false,"given":"Igor","family":"RUZZON","sequence":"additional","affiliation":[{"name":"Rocio Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-5039","authenticated-orcid":false,"given":"Caio Henrique Marchette","family":"GOVEIA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-3631","authenticated-orcid":false,"given":"Lucas Augusto Prestes","family":"GON\u00c7ALVES","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2021]]},"reference":[{"year":"2018","series-title":"N\u00famero de cirurgias bari\u00e1tricas no Brasil aumenta 46,7%","author":"Battistelli C","key":"ref1"},{"issue":"4","key":"ref2","article-title":"Fatores associados \u00e0 redu\u00e7\u00e3o do risco de complicac\u00b8o~es na cirurgia colorretal com cuidados peri-operato\u00b4rios recomendados pelo projeto ACERTO","volume":"32","author":"Bicudo-Salom\u00e3o A","year":"2019","journal-title":"ABCD Arq Bras Cir Dig"},{"issue":"5","key":"ref3","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1213\/ANE.0000000000003668","article-title":"Multimodal General Anesthesia Theory and Practice","volume":"127","author":"Brown EN","year":"2018","journal-title":"Anesth Analg"},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.soard.2016.09.013","article-title":"Acute pain management in morbid obesity - an evidence based clinical update","volume":"13","author":"Budiansky AS","year":"2017","journal-title":"Surg Obes Relat Dis"},{"issue":"2","key":"ref5","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1590\/S1806-00132011000200011","article-title":"A dor como um problema psicof\u00edsico","volume":"12","author":"Da Silva JA","year":"2011","journal-title":"Revista Dor"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1007\/s40262-017-0544-2","article-title":"Influence of Morbid Obesity on the Pharmacokinetics of Morphine, Morphine-3-Glucuronide, and Morphine-6-Glucuronide","volume":"56","author":"de Hoogd S","year":"2017","journal-title":"Clin Pharmacokinet"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/aas.12651","article-title":"Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2 consensus statement for anaesthesia practice","volume":"60","author":"Feldheiser A","year":"2016","journal-title":"Acta Anaesthesiol Scand"},{"key":"ref8","article-title":"Prevalence of obesity and associated factors in the Brazilian population a study of data from the 2013 National Health Survey","volume":"22","author":"Ferreira APS","year":"2019","journal-title":"Rev Bras Epidemiol"},{"issue":"Suppl 1","key":"ref9","first-page":"S59","article-title":"Neuropatia dolorosa p\u00f3s-traum\u00e1tica e p\u00f3s-operat\u00f3ria","volume":"17","author":"Fonseca PRB","year":"2016","journal-title":"Revista Dor"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","DOI":"10.1590\/0102-672020190001e1500","article-title":"Are obesity and adenoma development associated as colorectal cancer precursors","volume":"33","author":"Freitas BA","year":"2020","journal-title":"Arq Bras Cir Dig"},{"issue":"2","key":"ref11","first-page":"46","article-title":"Multimodal Analgesia and Alternatives to Opioids for Postoperative Analgesia","volume":"33","author":"Graff V","year":"2018","journal-title":"News Letter;"},{"issue":"CD001893","key":"ref12","first-page":"1","article-title":"Epidural local anesthetics versus opioid-based analgesic regimens for gastrointestinal paralysis, vomiting and pain after abdominal surgery","volume":"7","author":"Guay J","year":"2016","journal-title":"Cochrane Database of Systematic Reviews 2016 [E-book]"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/ALN.0b013e318220847c","article-title":"Thoracic epidural analgesia and acute pain management","volume":"115","author":"Manion SC","year":"2011","journal-title":"Anesthesiology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.2147\/JPR.S176468","article-title":"Pregabalin to improve postoperative recovery in bariatric surgery a parallel, randomized, double-blinded, placebo-controlled study","volume":"11","author":"Martins MJ","year":"2018","journal-title":"J Pain Res"},{"issue":"12","key":"ref15","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1097\/DCR.0000000000001226","article-title":"Thoracic Epidural Analgesia Does It Enhance Recovery?","volume":"61","author":"Rosen DR","year":"2018","journal-title":"Dis Colon Rectum"},{"issue":"4","key":"ref16","first-page":"285","article-title":"Epidemiology and incidence of acute and chronic Post-Surgical pain","volume":"86","author":"Sansone P","year":"2015","journal-title":"Ann Ital Chir"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","DOI":"10.1590\/0102-672020190001e1503","article-title":"Does evolutionary biology help the understanding of metabolic surgery A focused review","volume":"33","author":"Santoro S","year":"2020","journal-title":"Arq Bras Cir Dig"},{"issue":"1","key":"ref18","first-page":"1","article-title":"Obesity and Poverty","volume":"9","author":"Snyder U","year":"2004","journal-title":"Medscape Ob\/Gyn & Women's Health"},{"issue":"1","key":"ref19","article-title":"Implementa\u00e7\u00e3o do protocolo de recupera\u00e7\u00e3o otimizada ap\u00f3s cirurgia colorretal (ERAS) resultados iniciais da primeira experi\u00eancia brasileira","volume":"32","author":"Teixeira UF","year":"2019","journal-title":"ABCD Arq Bras Cir Dig"},{"issue":"1","key":"ref20","article-title":"Recupera\u00e7\u00e3o otimizada (ERAS) ap\u00f3s cirurgia hep\u00e1tica estudo comparativo de um centro terci\u00e1rio brasileiro","volume":"32","author":"Teixeira UF","year":"2019","journal-title":"ABCD Arq Bras Cir Dig"},{"issue":"1","key":"ref21","doi-asserted-by":"crossref","DOI":"10.1590\/0102-672020190001e1501","article-title":"Assessment of alveolar bone pattern in obese and non-obese women, before and after bariatric surgery a prospective cohort study","volume":"33","author":"Vargas JA","year":"2020","journal-title":"Arq Bras Cir Dig"}],"container-title":["ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/abcd\/v34n1\/0102-6720-abcd-34-01-e1530.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T17:57:59Z","timestamp":1621015079000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-67202021000100302&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"alternative-id":["S0102-67202021000100302"],"URL":"https:\/\/doi.org\/10.1590\/0102-672020200002e1530","relation":{},"ISSN":["2317-6326","0102-6720"],"issn-type":[{"type":"electronic","value":"2317-6326"},{"type":"print","value":"0102-6720"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e1530"}}