Bloqueios regionais na analgesia multimodal e reabilitação precoce após artroplastias: revisão integrativa
DOI:
https://doi.org/10.62827/fb.v27i8.1288Palavras-chave:
Dor Pós-Operatória; Deambulação Precoce; Recuperação de Função Fisiológica; Tempo de internação; Bloqueio Nervoso.Resumo
Introdução: O controle da dor após artroplastias deve favorecer mobilização sem impor déficit motor que atrase a fisioterapia. Objetivo: Sintetizar criticamente os efeitos de bloqueios regionais, inseridos em analgesia multimodal, sobre dor, opioides e recuperação precoce após artroplastias primárias de joelho ou quadril. Métodos: Revisão integrativa qualitativa. As buscas iniciais no PubMed/MEDLINE e na Physiotherapy Evidence Database ocorreram em julho e agosto de 2026; em setembro de 2026, foi realizada busca complementar sensível no PubMed/MEDLINE, reprodução das buscas no PEDro e inclusão da LILACS. Foram elegíveis estudos comparativos em adultos com desfecho analgésico associado a função precoce ou permanência. Um único autor realizou seleção, extração e apreciação por critérios do Mixed Methods Appraisal Tool, sem verificação independente. Resultados: Foram identificados 1.137 registros; 70 textos integrais foram avaliados e 60 estudos incluídos, 30 sobre joelho e 30 sobre quadril. Cinquenta e sete eram randomizados, três eram prospectivos não randomizados e 31 de 101 relatórios procurados não foram recuperados. Bloqueios sensitivos distais e estratégias motoras poupadoras reduziram dor ou preservaram força em parte dos ensaios, mas os efeitos sobre marcha e alta foram inconsistentes. Conclusão: Os benefícios funcionais foram heterogêneos e condicionados pelo comparador, pelas cointervenções e pelo programa de reabilitação; não há evidência de superioridade geral de uma técnica.
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