New approach to enteral nutrition in esophagojejunal fistulae

BACKGROUND: A new procedure for the treatment of esophageal fistula, mainly associated to the ebb esophagojejunal in patients submitted to the total gastrectomy and reconstruction with loop jejunal Rouxen-Y anastomosis is present. METHODS: The method is based in the use of probe standard enteral prolongated with drain to laminate adapted in extremity, which results in advanced positioning inside the jejunum, making the administration of enteral nutrition possible and impeding ebb esophagojejunal. RESULTS: The authors discuss the theoretical advantages of the procedure and they suggest that the treatment of esofagic fistula with probe prolonged enteral would be suitable in the treatment of the fistula esophagojejunal by preventing the ebb esophagojejunal, which would result in smaller period of duration of the fistula esophagojejunal and it would prevent the high mortality rate. CONCLUSIONS: Preliminary studies demonstrated that this is a technically easy, low cost procedure through the endoscopic use. A prospective evaluation for morbility and mortality related to the method is needed.Universidade Federal de Mato Grosso do Sul Depto. de Clínica CirúrgicaUNIFESP-EPM Depto. de CirurgiaServiço de EndoscopiaUNIFESP, EPM, Depto. de CirurgiaSciEL

The role of pneumoperitoneum in the respiratory and hemodynamic evaluation in anaesthetized rats, with or without intubation

BACKGROUND: To investigate hemodynamic and respiratory changes in rats submitted to CO2 pneumoperitoneum or not, under anesthesia with and without endotracheal intubation. METHODS: Male albino rats (n = 40), average weight of 300g, three months aged, were randomized: GA - anesthesia with endotracheal intubation for one hour with CO2 pneumoperitoneum (4mmHg); GB - anesthesia without intratracheal intubation for one hour with CO2 pneumoperitoneum (4mmHg); GC - anesthesia without endotracheal intubation for one hour without pneumoperitoneum; GD - anesthesia with endotracheal intubation for one hour without pneumoperitoneum. Median arterial pressure (MAP- mmHg), heart rate (HR-beat/min), respiratory frequency (RF - rm/min), central venous pressure (CVP - cmH2O), peripheral oxygen saturation (STO2), partial CO2 pressure (PaCO2), arterial bicarbonate (HCO3-), oxygen saturation (SO2) and pH were recorded. Measurements were performed at the begining of the procedure (MO) and after, 30 minutes (M1) and 60 minutes (M2). RESULTS: In GA and GC (groups with CO2 pneumoperitoneum) there was an increase of MAP, PaCO2, HCO3-, HR, CVP and decrease of pH, CO2, STO2 in comparison with those without pneumoperitoneum. On the other hand, endotracheal intubation attenuated these changings during the first hour of anesthesia. CONCLUSION: General anesthesia with endotracheal intubation, associated to CO2 pneumoperitoneum (4 mmHg) during one hour, proved advantageous in hemodynamic and respiratory systems, in relation to the animals with pneumoperitoneum without endotraqueal intubation, and to those within four hour of anesthesia, in spite of intubation.OBJETIVO: Estudar as alterações hemodinâmicas e respiratórias em ratos submetidos ou não ao pneumoperitônio com CO2, sob anestesia com ou sem intubação intratraqueal. MÉTODO: Ratos machos (n = 40), albinos, com peso médio de 300g, idade de três meses, foram randonizados em quatro grupos: GA - anestesia com intubação endotraqueal por uma hora e com pneumoperitônio de 4mmHg de CO2; GB - anestesia sem intubação endotraqueal por uma hora e com pneumoperitônio de 4mmHg de CO2; GC - anestesia sem intubação endotraqueal por uma hora e sem pneumoperitônio; GD - anestesia com intubação endotraqueal por uma hora, sem pneumoperitônio. Foram registrados os valores da pressão arterial média (PAM), pressão parcial de gás carbônico (pCO2), freqüência cardíaca (FC), freqüência respiratória (FR), pressão venosa central (PVC), potencial hidrogeniônico acidose (pH), saturação de oxigênio periférico (spO2), bicarbonato (HCO3-) e saturação de oxigênio no sangue arterial (SO2,). Os dados foram coletados no início do experimento (M0), após 30 minutos (M1) e após 60 minutos (M2). RESULTADOS: Em GA e GC (grupos com pneumoperitônio) ocorreu aumento da PAM, PCO2, HCO3-, FR, PVC e uma diminuição do pH, SO2, spO2 e da FC em relação aos animais sem pneumoperitônio. Por outro lado a intubação intratraqueal demonstrou atenuar estas alterações nos animais com até uma hora de anestesia. CONCLUSÃO: A anestesia geral com intubação endotraqueal associada ao pneumoperitônio de 4mmHg, por um período de uma hora, mostrou vantagens do ponto de vista respiratório e hemodinâmico, em relação aos animais com pneumoperitônio e sem intubação e também sobre aqueles com até quatro horas de anestesia, apesar da intubação.UNIFESP-EPMUNIFESP-EPM Departamento de CirurgiaUniversidade de Santo AmaroUNIFESP, EPM, Depto. de CirurgiaSciEL

Efeitos da lesão estrutural na contaminação bacteriana biliar após a esfincteroplastia transduodenal (dilatação papilar) em cães

PURPOSE: To evaluate, in dogs, the biliary sphincter subjected to dilation by hydrostatic balloon by the point of view of structural alterations of the papilla and the biochemestry and bacterial contamination of the bile. METHODS: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10) - with balloon of 8mm inflated with pressure of 0,5atm, during 2 minutes or to the sham procedure - GB(n=10). Blood samples collected on times t(0day), t(7days) and t(28days) were subjected to dosages of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) for cholestasis evaluation. The collected material from the gall bladder at the same times were registered and numbered to be submitted to culture in BHI, blood agar (rich, non-selective element) and Mac Conkey (selective element for Gram-negative bacillus. On the 28th day three fragments of the papilla were tranversally cut by the choledoc axis 3mm from the duodenal papilla and the cuts, stained with hematoxylin-eosin and Masson's tricome, were evaluated according to their inflammatory reaction. RESULTS: The GGT and ALP averages on the three periods in the groups A and B did not show significant differences, not being characterizes the cholestasis. The bacterian contamination was significantly higher in GA (2,19) than in GB (1,96); the contamination was lower in the initial time compared with 7 and 28 days (t0<t7 and t28) in GA and GB (t0<t28). The chronic inflammatory alteration of the mucosa occurred in 60% of the GA animals and in 80% of the GB animals. There was not mural inflammation. CONCLUSION: The duodenal papilla dilation or its simple manipulation leads to the bacterial contamination of the gall bladder, not associated with cholestasis. The morphologic lesions are more intense in the late phase, not associated with an eventual papilla esthenosis.OBJETIVO: Avaliar, em cães, a papila duodenal maior submetida à dilatação por balão hidrostático sob o ponto de vista das alterações estruturais da papila e da bioquímica e contaminação bacteriana da bile. MÉTODOS: Vinte cães foram submetidos a laparotomia, duodenotomia, dilatação da papila maior GA (n=10) - com balão de 8mm insuflado com pressão de 0,5atm, durante 2 minutos ou ao procedimento simulado - GB(n=10). Amostras de sangue coletadas nos tempos t(0dia), t(7dias) e t(28dias) foram submetidas às dosagens da fosfatase alcalina (FA) e gama-glutamil-transferase (GGT) para avaliação da colestase. Material colhido da vesícula biliar nos mesmos tempos foi registrado e numerado para ser submetido à cultura em BHI, ágar sangue (meio rico não seletivo), e Mac Conkey (meio seletivo para bacilos Gram-negativos). No 28º. dia três fragmentos da papila forma cortados transversalmente ao eixo do colédoco a 3mm da papila duodenal e os cortes corados em hematoxilina-eosina e tricômio de Masson e avaliados quanto a reação inflamatória. RESULTADOS: As médias da GGT e da FA nos três períodos nos grupos A e B não mostraram diferenças significantes, não sendo caracterizada a colestase. A contaminação bacteriana foi significante maior em GA(2,19) que no GB(1,96); a contaminação foi menor no tempo inicial em relação aos 7 e 28 dias( t0<t7 e t28) no GA e no GB (t0<t28). A alteração inflamatória crônica da mucosa ocorreu em 60% dos animais do GA e em 80% do GB. Não houve inflamação mural. CONCLUSÃO: A dilatação da papila duodenal ou a sua simples manipulação leva a contaminação bacteriana da vesícula biliar, não associada à colestase. As lesões morfológicas são mais intensas na fase aguda e não correspondem a lesões crônicas mais extensas na fase tardia, não estando associadas a uma eventual estenose da papila.State University of Maringá Surgery DepartmentUNIFESPUNIFESPSciEL

Effects of repeated extracorporeal shock wave on kidney apoptosis of normal and diabetic rat

OBJECTIVE: To assess the effect of repeated extracorporeal shock waves (ESW) on the apoptosis of renal parenchyma in normal and diabetic rats by the caspase-3 expression. MATERIALS AND METHODS: 80 rats were assigned for ESW (Direx Tripter X1® - 14 KVA) to one of three groups with 50% rats with diabetes (A) and 50% normal (B) in each: G1 (n = 40): no ESW; G2 (n = 20): one ESW; G3 (n = 20): two ESWin an interval of 14 days. The animals were sacrificed 3 days after the ESW and samples of the renal parenchyma were histologically prepared, stained by the caspase-3 cleavage immunohistochemical method, and the apoptotic index (ApIn) was calculated by computer program Image Pro-Plus V 4,5,1 Media Cybernetics® ( ApIn = number of apoptotic cells in the microscopic section / total cells in the microscopic section). RESULTS: There was no statistical difference in ApIn of normal rats with one ESW (8.4 + 0.2) or two ESW (9.1 + 0.3) and both were similar to the control group with no ESW (7.9 + 0.2). The ApIn of diabetic rats with one ESW (7.4 + 0.3) was similar to the normal rats with one or two ESW. On the other hand, the ApIn was statistically higher in diabetic rats with two ESW (11.9 + 0.4) than in diabetic rats with one ESW (7.4 + 0.3). CONCLUSIONS: The ApIn of normal rats with a single (2,000 SW) or repeated ESW (4,000 SW) was similar to the control animals without any ESW. In diabetic rats, the repeated ESW (4,000 SW) may result in an additional risk of tissue damage expressed by the higher ApIn.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of SurgeryUNIFESP, EPM, Department of SurgerySciEL

Tratamento da ptose mamária bilateral e do pectus excavatum através da mesma incisão no mesmo tempo cirúrgico

CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.CONTEXTO: Deformidades congênitas da parede torácica anterior são caracterizadas pelo desenvolvimento anormal das cartilagens costais. Todas essas afecções são frequentemente associadas com as mais diferentes deformidades da mama. Várias técnicas cirúrgicas têm sido utilizadas para a correção desde as esternocondroplastias até, atualmente, técnicas minimamente invasivas e próteses de silicone. RELATO DE CASO: O presente artigo relata o caso de uma paciente jovem que apresentava ptose mamária bilateral e uma forma moderada de pectus excavatum que ocasionava uma protrusão entre a oitava e a décima costelas, tendo como consequencia a desarmonia estética. O tratamento cirúrgico proposto incluiu, além de implantes mamários sub-glandulares de poliuretano, ressecção de parte da cartilagem da costela e parte do segmento ósseo da oitava, nona e décima costelas por uma única incisão sub-mamária para tornar a cicatriz minimamente visível. A correção por meio de uma única incisão beneficiou a paciente, proporcionando excelente resultado estético. CONCLUSÕES: As técnicas utilizadas para reparação da ptose mamária bilateral e do pectus excavatum pelas equipes de cirurgia plástica e torácica, respectivamente, demonstraram-se eficazes para correção de ambas as deformidades. Foi obtido ótimo resultado estético e funcional com consequente retomada da auto-estima da paciente.Universidade Católica de PelotasUniversidade Federal de PelotasUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Division of Operative Technique and Experimental SurgeryUNIFESP, Department of Surgery Division of Operative Technique and Experimental SurgerySciEL

O papel do precondicionamento isquêmico do músculo grácil de ratos na fase precoce da reperfusão

PURPOSE: Verify the role of ischemic preconditioning (IPC) in ischemia and reperfusion injury on gracilis muscle of rats. METHODS: Wistar rats (n=30) were distributed in three groups, I/R and IPC groups were subdivided concerning ischemia time. A near-amputation model of the posterior limb was produced by a hip joint level incision, preserving the vascular bundle and the femur bone and ischemia was induced for 2h and 4h, G-I 2h/R (n=6) and G-I 4h/R (n=6), followed by 1h of vascular reperfusion. The preconditioned groups, G-PCI 2h (n=6) and G-PCI 4h (n=6), were preceded by 3 cycles of 5min of ischemia followed by 5min of vascular reperfusion before sustained ischemia. In the Control Group, C-G (n=6) animals were subjected to regional approach. The analysis was done with Light Microscopy (LM). RESULTS: The levels of fibril fragmentation were progressive in the G-I 2h/R (67% of muscle preservation) and in the G-I4 h/R (0% of muscle preservation). However in the group of the precondition the lesion degree being in level similar to the group controls in the G-I 2h/R (100% of muscle preservation) while at G-I 4h/r occur less protection (67% of muscle preservation). The degree of tissue inflammatory reaction was worst at G-I 4h/R (0% without inflammation signals) than at G-I 2h/R (50% without inflammation signals); while in the precondition group G-IPC-2h (83% without inflammation signals) was better than the G-IPC-4h (67% without inflammation signals). The vascular stasis was absent only in 17% of the G-I 4h/R and in 33% of the G-I 2h/R. In precondition group, however, the vascular stasis was absent in 33% at G-IPC 2h and absent in 50% at G-IPC 4h. CONCLUSION: The IPC showed, in an earlier phase, a benefic role at I/R derived injury on gracilis muscle of rats, as proven for the largest preservation of the fibers muscular, smaller inflammatory reaction and smaller vascular stasis.OBJETIVO: Verificar o papel do precondicionamento isquêmico (PCI) na lesão de isquemia e reperfusão (I/R) do músculo grácil de ratos. MÉTODOS: Trinta ratos Wistar foram distribuídos em três grupos, sendo G-I/R e G-PCI subdivididos em relação ao tempo de isquemia. Produziu-se modelo de quase-amputação do membro posterior por meio de uma incisão, preservando o feixe vascular e o osso femoral, induzindo-se isquemia por 2h e 4h, G-I 2h/R (n=6) e G-I 4h/R (n=6), seguida por 1h de reperfusão. Os Grupos Precondicionados, G-PCI 2h (n=6) e G-PCI 4h (n=6), foram precedidos por 3 ciclos de 5min de isquemia seguidos de 5min de reperfusão, antes da isquemia sustentada. No Grupo Controle, G-C (n=6) realizou-se apenas a abordagem regional. As avaliações morfológicas foram realizadas por meio de Microscopia Óptica (MO) para avaliação da desestruturação miofibrilar, processo inflamatório e estase venosa no tecido do músculo grácil. Foram atribuídos escores semi-quantitativos às variáveis estudadas. RESULTADOS: Houve preservação miofibrilar de 76% em G-I2h/R e 0% em G-I4h/R; G-IPC 2h a preservação foi de 100% e de 67% em G-IPC 4h. A reação inflamatória foi mais acentuada em G-I 4h (100% com inflamação) do que em G-I2h (50%);G-IPC 2h apresentou 82% sem inflamação e G-IPC 4h apresentou 67% sem inflamação. A estase vascular esteve ausente em 17% do G-I 4h e em 33% do G-I 2h; em G-IPC 2h esteve ausente em33% e em G-IPC 4h em 50%. CONCLUSÃO: O PCI mostrou, em uma fase inicial, papel benéfico na lesão de I/R no músculo grácil de ratos, comprovado pela maior preservação das fibras musculares, menor reação inflamatória e menor estase venosa.Federal University of São Paulo EPMFederal University of São Paulo Surgery DepartmentFederal College Foundation of Porto AlegreLutheran University of Brazil Electronic Microscopy LaboratoryUNIFESP, EPMUNIFESP, Surgery DepartmentSciEL

Oxygen consumption of rats with broad intestinal resection

The study was performed to investigate possible alterations in oxygen consumption in an animal model with broad intestinal resection. Oxygen consumption and the thermal effect of a short meal were measured in rats subjected to short bowel syndrome. Four groups of rats were used. Group I was the control group, group II was sham operated, group III was submitted to 80% jejunum-ileum resection, and group IV was submitted to 80% jejunum-ileum resection with colon interposition. Ninety days after surgery, oxygen consumption was measured over a period of 6 h with the animals fasted overnight. The thermal effect of feeding was determined in another session of oxygen consumption measurement in animals fasted for 12 h. A 12-kcal meal was then introduced into the animal chamber and oxygen consumption was measured for a further 4 h. No differences in fasting oxygen consumption or in the thermal effect of the meal were detected among the groups studied. It is concluded that short bowel syndrome does not affect the overall energy expenditure of rats.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de FisiologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de CirurgiaUNIFESP, EPM, Depto. de FisiologiaUNIFESP, EPM, Depto. de CirurgiaSciEL

Does hyperbaric oxygenation have a protective effect on random skin flaps?: an immunohistochemical study of cellular apoptosis and vascular endothelial growth factor

BACKGROUND: Hyperbaric oxygenation (HBO) therapy aims to increase oxygen tissue pressure by at least 10 times and decrease the adverse effects of ischemia. The aim of this study was to investigate the effect of HBO on the immunohistochemical expressions of caspase 3 and vascular endothelial growth factor (VEGF) in random flaps in rats. METHODS: Thirty-two male Wistar rats were randomly divided into 4 groups: the sham group (GS), the N-acetylcysteine group (GNAC), the HBO group, and the HBO + N-acetylcysteine group. A rectangular skin flap (2 × 8 cm) was dissected from the dorsal muscle layer, and a cranial pedicle was preserved. A polyethylene film was placed on the muscle layer, and the flap was fixed in the original site. On the eighth day, biopsy samples (2 × 1 cm) of the entire thickness of the proximal, medial, and cranial areas as well as of the site outside the flap, which was used as a control, were collected. RESULTS: VEGF expression in the skin layers and vessels was not significantly different between the groups. The number of apoptotic cells was significantly increased in the area of the flap in all groups. The highest increase was noted in the GS and GNAC groups. HBO significantly reduced the number of caspase 3-positive cells in the skin layers and vessels of the 3 areas. CONCLUSIONS: HBO was associated with decreased apoptosis. VEGF expression in the skin layers and vessels did not differ significantly. The results suggest that oxygen diffusion through the interstitial space was the determining factor for the positive effect of HBO on the decrease in apoptosis.INTRODUÇÃO: A oxigenação hiperbárica (OHB) tem por objetivo aumentar em pelo menos 10 vezes a pressão tecidual de oxigênio, diminuindo os efeitos deletérios da isquemia. O objetivo deste estudo é investigar o papel da oxigenação hiperbárica na expressão imuno-histoquímica da caspase 3 e do fator de crescimento endotelial vascular (VEGF) em retalhos randômicos em ratos. MÉTODO: Trinta e dois ratos Wistar machos foram divididos aleatoriamente em quatro grupos: grupo sham (GS), grupo N-acetilcisteína (GNAC), grupo OHB (GOHB) e grupo OHB + N-acetilcisteína (GHN). Um retalho de pele retangular (2 cm x 8 cm) foi dissecado a partir da camada muscular dorsal, preservando um pedículo cranial. Uma lâmina de polietileno foi colocada sobre a camada muscular e fixou-se o retalho no local original. No 8º dia, foram coletadas biópsias (2 cm x 1 cm) de espessura total das áreas proximal, média e cranial e de um local fora do retalho, que serviu como área de controle. RESULTADOS: A expressão de VEGF nas camadas da pele e nos vasos não apresentou diferenças significativas entre os grupos. As células apoptóticas estavam significativamente aumentadas na área central do retalho em todos os grupos. O maior aumento ocorreu nos grupos GS e GNAC. A OHB diminuiu significativamente o número de células caspase 3 positivas nas camadas da pele e nos vasos das três áreas. CONCLUSÕES: A OHB foi associada a expressão reduzida de apoptose. A expressão de VEGF em camadas da pele e vasos não demonstrou diferença significativa. Os resultados sugerem que a difusão do oxigênio através do espaço intersticial foi o fator determinante para os resultados mais favoráveis da OHB na diminuição da expressão de apoptose.Sociedade Brasileira de Cirurgia PlásticaUniversidade Católica de Pelotas Departamento de CirurgiaUniversidade Federal de São Paulo (UNIFESP) Departamento de CirurgiaUniversidade Federal de PelotasUniversidade Federal de Pelotas Liga Acadêmica de Cirurgia PlásticaUNIFESP, Depto. de CirurgiaSciEL

Surgical adhesives and tubal sterilization: an experimental study

Aim: Our aim was to assess the application of three currently used surgical adhesives in the tubal lumen of rabbits, to promote sterilization, using a transvaginal approach. Methods: Fifty-seven female albino New Zealand rabbits (114 uterine tubes), which became pregnant and delivered before the experiment, were divided into four groups: GS (sham-24 tubes), GEFIBRI (0.25 mL of fibrin adhesive in 30 tubes), GE-GRF (0.25 mL of resorcin adhesive in 30 tubes) and GEBUTYL (0.25 mL of n-butyl-2-cyanoacrylate adhesive in 30 tubes). The animals were mated with proven fertile males after the experiment and observed over 30, 90 and 180 days. Pregnancy and patency were macroscopically evaluated. The tubal diameter, tubal mucosa, myosalpinx, total optical density and inflammatory process were microscopically evaluated. The statistical analysis was performed by McNemar andWilcoxon tests for the subgroups, and Fisher’s exact test and Kruskal–Wallis test for the groups, the differences identified by Dunn’s multiple comparisons test (P = 5%). Results: GS showed patency and pregnancies in all subgroups. GEFIBRI showed patency and pregnancies in all subgroups. GE-GRF did not show patency or pregnancies, but was associated with severe inflammatory process and tubal morphology alterations. GEBUTYL did not show patency, pregnancies or morphological tubal mucosa alterations. Conclusions: The n-butyl-2-cyanoacrylate adhesive effectively promoted tubal obstruction, did not cause tubal morphological alterations, nor did it impair the rabbit pregnancy. The fibrin adhesive failed to cause the occlusion. The GRF adhesive, in spite of producing tubal occlusion, caused severe uterine tubes damage

Efeitos analgésico e hipnótico das associações do sufentanil com o tiopental e com o propofol, em ratos

The aim of this study was to evaluate the interactions of the analgesic action of sufentanil with the hypnotic action of thiopental and propofol, in 60 male rats distributed in two groups of 30 and submitted to different doses of sufentanil and propofol, to determine the analgesic (AMD) and hypnotic medium doses (HMD). The AMD of sufentanil was the analgesic dose and HMD of thiopental and propofol was the dose to obtain hypnosis, this is, the lost of righting reflex. There was a prolonged hypnotic action when thiopental with sufentanil and propofol with sufentanil were used together. The analgesic action of sufentanil-thiopental association has a significant increase, and sufentanil-propofol association showed no significant difference when compared to sufentanil alone. The sufentanil-thiopental association had more analgesic and hypnotic action when compared to sufentanil-propofol association. When was compared the concomitant presence of analgesy and hypnosis, the sufentanil-thiopental association had a longer lasting.O objetivo deste estudo foi avaliar a ação analgésica do sufentanil com a ação hipnótica do tiopental e do propofol, os quais foram ministrados por via intraperitoneal, em 60 ratos Wistar. Os animais foram distribuídos em dois grupos de 30 e submetidos a diferentes doses de sufentanil, tiopental e propofol para determinação das doses, analgésica e hipnóticas, médias. A dose do sufentanil foi determinada com estímulos padronizados pelo pinçamento da cauda do animal. Enquanto que com o tiopental e o propofol objetivou-se a dose hipnótica média, onde a resposta foi a perda de postura. Da interação do tiopental com o sufentanil obteve-se uma ação hipnótica aumentada e prolongada. Enquanto, o propofol associado ao sufentanil mostrou um início mais lento, porém com maior duração da ação hipnótica. Com relação à ação analgésica da associação do tiopental e sufentanil, obteve-se um aumento significante. Enquanto, na associação do propofol com sufentanil não se detectou diferença significante. A associação do tiopental com sufentanil apresentou maior potência hipnótica e analgésica quando comparada à associação do propofol com sufentanil. Da mesma forma, quando se observou a presença concomitante de hipnose e analgesia, a associação do tiopental com sufentanil apresentou uma ação mais longa do que o propofol com sufentanil.Faculdade de Ciências Médicas de Pouso Alegre-MGEscola Paulista de Medicina - UNIFESPFaculdade de Ciências Médicas de Pouso AlegreUNIFESP, EPM, UNIFESPSciEL