medigraphic.com

2008, Número 2

<< Anterior Siguiente >>

Rev Mex Anest 2008; 31 (2)


Analgesia postoperatoria con nimesulida vs metamizol en apendicectomías. Estudio prospectivo aleatorio

Paz-Estrada C, Rodríguez-López J, Fuentes-Pérez M

Idioma: Español
Referencias bibliográficas: 38
Paginas: 79-83
Archivo PDF: 481.25 Kb.


RESUMEN

Antecedentes: Una de las técnicas de analgesia preventiva para tratar el dolor postoperatorio incluye el uso de analgésicos antiinflamatorios no esteroideos convencionales. Objetivo: Comparar la eficacia analgésica postoperatoria de nimesulida frente a metamizol en apendicectomías. Material y método: Se realizó ensayo clínico controlado, en el Hospital «Guillermo Luis Fernández Hernández-Baquero», Holguín, Cuba, durante un período de diez meses. Se seleccionaron 88 pacientes, los cuales se dividieron al azar en dos grupos de 44 pacientes cada uno: Grupo I: nimesulida 200 mg, vía oral, 120 minutos antes del proceder quirúrgico y Grupo II: metamizol 2 g intravenoso, luego de inducción de la anestesia. Se premedicaron con midazolam 0.02 mg/kg IV. Aplicamos anestesia general orotraqueal y se registró tensión arterial media, frecuencia cardíaca y saturación de la hemoglobina en varias etapas del perioperatorio así como los efectos adversos más frecuentes. Se midió la intensidad del dolor en el postoperatorio a través de la escala visual análoga. Resultados: Se observó una disminución del dolor en el postoperatorio en ambos grupos, más marcado con los pacientes del Grupo II, no siendo significativo a las 6 horas (p = 0.277). Los efectos adversos encontrados en el Grupo I: vómitos en 2 pacientes. En el Grupo II náuseas en 8 casos y vómitos en 6 pacientes. Conclusiones: La administración de nimesulida y metamizol resultaron eficaces al ser utilizados como analgesia preventiva en cirugía de apendicectomía.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. McQuay HJ. Preventive analgesia a systematic review of clinical studies. Ann-Med 1995;27:249-52.

  2. Gottin L, Finco G, Polati E. The Preventive analgesia in the treatment of postoperative pain. Chir Ital 1995;47:12-9.

  3. Wall PD. The prevention of acute pain. 1988;33:298-290.

  4. Woolf CJ. Central mechanisms of acute pain. In: Board MR, Charttan JE, Woolf CJ (eds). Proc of the IV World Congress of Pain, Elsevier. Amsterdan 1991:25-34.

  5. Katz J, Kavavagh B. Preventive analgesia: Clinical evidence of neuroplasticy contributing to postoperatives pain. Anesth 1992;77:439-446.

  6. Hermann M, Ruschitzka F. Cardiovascular risk of cyclooxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs. Ann Med 2007;39:18-27.

  7. Saray A, Buyukkocak U, Cinel I, Tellioglu AT, Oral U. Diclofenac and metamizol in postoperative analgesia in plastic surgery. Acta Chir Plast 2001;43:71-6.

  8. Cheer SM, Goa KL. Parecoxib (Parecoxib sodium). Drugs 2001;61:1133-1141.

  9. Jain KK. Evaluation of intravenous Parecoxib for the relief of acute post-surgical pain. Expert Opin Investig Drugs 2000;9:2717-2723.

  10. Daniels SE, Grossman EH, Kuss ME, Talwalker S, Hubbard RC. A double- blind, randomized comparison of intramusculary and intravenously administered Parecoxib sodium versus Ketorolac and placebo in a post- oral surgery pain model. Clin Ther 2001;23:1018-1031.

  11. Ganem EM, Thadeu P, Marcodes Y. Effects of different doses of tenoxicam on spinal cord and meninges experimental study in dogs. Brazz J. Anesthesiol Int Issue 2000;50:60-62.

  12. Pohjolainen T, Jekernen A. Treatment of acute low back pain with COX-2-Selective antinflammatory drug nimesulide: result to a randomized, double blind comparative trial vs ibuprofen. Spine 2000;15-25:1579-85.

  13. Vizzardi M, Visconti CS, Pedrotti L. Nimesulide beta ciclodextrin (nimesulide Betadex) vs Nimesulide in the treatment of pain after arthroscopy surgery. Current Therapeutic Research-Clinical and Experimental 1998;59:162-171.

  14. Bianchi M, Broggini M, Anti-hyperalgesic effects of nimesulide: studies in rats and humans. Int J Clin Pract Suppl 2002;128:11-9.

  15. Bracco P, Debernardi C, Coscia D, Pascualini D, Pascualiccho F, Calabrese N. Efficacy of rofecoxib and nimesulide in controlling postextraction pain in oral surgery: a randomized comparative study. Curr Med Res Opin 2004;20:573-4.

  16. McCrory C, Fitzgerald D. Spinal prostaglandin formation and pain perception following thoracotomy: a role for cyclooxygenase-2. Chest 2004;125:1321-7.

  17. McCrory C, Diviney D, Moriarty J, Luke D, Fitzgerald D. Comparison between repeat bolus intrathecal morphine and an epidurally delivered bupivacaine and fentanyl combination in the management of post-thoracotomy pain with or without cyclooxygenase inhibition. J Cardiothorac Vasc Anesth 2002;16:607-11.

  18. Ramella G, Costagli V, Vetere M, Capra C, Casella G, Sogni A, et al. Comparison of nimesulide and diclofenac. in the prevention and treatment of painful inflammatory postoperative complications of general surgery. Drugs 1993;46:159-61.

  19. Coscarelli S, Scaricabarozzi I, Nava ML, Alajmo E. A comparison of nimesulide and ketoprofen in the prevention and treatment of painful postoperative inflammatory complications of ear, nose and throat surgery. Drugs 1993;46:174-6.

  20. Ferrari Parabita G, Zanetti V, Scalvani F, Rossi D, Scaricabarozzi I. A controlled study of the efficacy and tolerability of nimesulide vs naproxen in maxillofacial surgery. Drugs 1993;46:171-3.

  21. Riverso P, Rezzonico C, Giacometti B, Bertolini M. Nimesulide in the treatment of postoperative pain in minor orthopaedic surgery. Minerva Med. 1990;81:95-6.

  22. Vanegas H, Schaible HG. Prostaglandins and cyclooxygenases in the spinal cord. Prog Neurobiol 2001;64:327-363.

  23. Yaksh TL, Dirig DM, Conway CM. The acute antihyperalgesic action of nonsteroidal anti-inflammatory drugs and released of spinal prostaglandin E2 is mediated by the inhibition of constitutive spinal cyclooxygenase-2 (COX-2) but not COX-1. J Neurosci 2001;21:5847-5853.

  24. Samad TA, Moore KA, Sapirstein A. Interleukin-1 beta mediated induction of COX-2 in the CNS contributes to inflammatory pain hypersensitivity. Nature 2001;410:471-475.

  25. Oberhofer D, Skok J, Nesek-Adam V. Intravenous ketoprofen in postoperative pain treatment after major abdominal surgery. World J Surg 2005;29:446-9.

  26. Landwehr S, Kiencke P, Giesecke T, Eggert D, Thumann G, Kampe S. A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery. Curr Med Res Opin 2005;21:1569-75.

  27. Grundmann U, Wornle C, Biedler A, Kreuer S, Wrobel M, Wilhelm W. The efficacy of the non-opioid analgesics parecoxib, paracetamol and metamizol for postoperative pain relief after lumbar microdiscectomy. Anesth Analg 2006;103: 217-22.

  28. Stamer UM, Hothker F, Lehnen K, Stuber F. Postoperative analgesia with tramadol and metamizol. Continual infusion versus patient controlled analgesia. Anaesthesist 2003;52:33-41.

  29. Montes A, Warner W, Puig MM. Use of intravenous patient-controlled analgesia for the documentation of synergy between tramadol and metamizol. Br J Anaesth 2000;85:217-23.

  30. Lehmann KA, Paral F, Sabatowski R. Postoperative pain therapy with hydromorphone and metamizole. A prospective randomized study in intravenous patient-controlled analgesia (PCA). Anaesthesist 2001;50:750-6.

  31. DeLoach LJ, Higgins MS, Caplan AT, et al. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg 1998;86:102-106.

  32. Kampe S, Warm M, Landwehr S, Dagtekin O, Haussmann S, Paul M, et al. Clinical equivalence of IV paracetamol compared to IV dipyrone for postoperative analgesia after surgery for breast cancer. Curr Med Res Opin 2006;22:1949-54.

  33. Rawal N, Allvin R, Amilon A, Ohlsson T, Hallen J. Postoperative analgesia at home after ambulatory hand surgery: a controlled comparison of tramadol, metamizol and paracetamol. Anesth Analg 2001;92:347-51.

  34. Torres LM, Rodriguez MJ, Montero A, Herrera J, Calderon E, Cabrera J, et al. Efficacy and safety of dipyrone versus tramadol in the management of pain alter hysterectomy: a randomized, double-blind, multicenter study. Reg Anesth Pain Med 2001;26:118-24.

  35. Yilmaz I, Sener M, Yavuz H, Yilmazer C, Erkan AN, Cagici CA, et al. Postoperative pain management in clinics of otolaryngology. Kulak Burun Bogaz Ihtis Derg 2006;16:1-6.

  36. Kaufmann J, Yesiloglu S, Patermann B, Krombach J, Kiencke P, Kampe S. Controlled-release oxycodone is better tolerated than intravenous tramadol/metamizol for postoperative analgesia after retinal-surgery. Curr Eye Res 2004;28:271-5.

  37. Weiss P, Movallem M, Bruck R, Hassin D, Tanay A, Brickman CM, et al. Nimesulide induce hepatitis and acute liver failure. Isr Med Assoc J 1999;1:89-91.

  38. Alotti N, Bodo E, Gombocz K, Gabor V, Rashed A. Management of postoperative inflammatory response and pain with nimesulide after cardiac surgery. Orv Hetil 2003;144:2353-7.




2020     |     www.medigraphic.com