BLOQUEIO DE NERVOS PERIFÉRICOS COMO TRATAMENTO CIRÚRGICO DE CEFALEIA POR USO EXCESSIVO DE MEDICAMENTOS: RELATO DE DOIS CASOS
DOI:
https://doi.org/10.53612/recisatec.v2i1.73Palavras-chave:
cabeça de uso excessivo de drogas (EMC) é uma dor de cabeçaResumo
A cefaleia por uso excessivo de medicamentos (CEM) é uma cefaleia secundária, que ocorre por 15 ou mais dias por mês em pacientes com diagnóstico preexistente de cefaleia primária, que leva ao consumo excessivo regular de medicamentos sintomáticos para a cefaleia por 10 dias nos casos de ergotamina, triptanos, opioides e combinações de analgésicos, ou por mais de 15 dias nos casos de analgésicos não opioides, paracetamol e anti-inflamatórios não esteroidais por mês, por mais de 3 meses. A CEM é uma das doenças incapacitantes que mais teve a incidência aumentada desde a década de 1990. A principal medida terapêutica é a retirada do medicamento utilizado em excesso. Entretanto, alguns pacientes não respondem completamente ao protocolo de retirada e, além disso, aqueles que apresentaram melhora, ainda continuam com quadros de cefaleia mensais, embora o suficiente para não serem diagnosticados com CEM. Os bloqueios anestésicos são um recurso para o manejo de diferentes cefaleias, seja como tratamento isolado ou combinado, seja para o tratamento da cefaleia rebote após a retirada de medicamentos. Os anestésicos locais são capazes de interromper de maneira reversível a condução do impulso nervoso mediante o bloqueio dos canais de sódio voltagem-dependentes, por meio de sua fração não ionizada, assim reduzindo a excitabilidade celular. Assim, este estudo teve como objetivo relatar o uso do bloqueio de nervos periféricos como tratamento alternativo e eficaz para a CEM.
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