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2010, Número 2

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Cir Cir 2010; 78 (2)


Coadyuvantes analgésicos en dolor por cáncer. Utilización de la herramienta de preguntas clínicas de PubMed

Chaparro-Gómez LE, Calvache-España JA, Arbeláez-León LM

Idioma: Español
Referencias bibliográficas: 46
Paginas: 189-194
Archivo PDF: 194.66 Kb.


RESUMEN

Los coadyuvantes en cáncer son medicamentos que adicionados a la terapia opioide pueden disminuir el requerimiento de ésta y los efectos adversos relacionados con su uso. El objetivo de este artículo es revisar no solo la evidencia, sino también los mecanismos de acción y esquemas de tratamiento de estas drogas. Realizamos una revisión cualitativa de la literatura utilizando la herramienta de preguntas clínicas de PubMed, seleccionando los ensayos clínicos y las revisiones sistemáticas que evaluaran analgesia oral o transdérmica en cáncer. Excluimos los artículos que analizaron la efectividad primaria de opioides, antiinflamatorios y esteroides, además de intervenciones perioperatorias. Suplementamos la información con revisión de los mecanismos de acción de estos medicamentos y esquemas de dosificación. Identificamos una revisión sistemática que evaluaba ketamina y ensayos clínicos que apoyan el uso de gabapentina, amitriptilina y nitroglicerina transdérmica. Encontramos, además, ensayos negativos de gabapentina y lamotrigina en dolor por quimioterapia. Evidencia muy débil soporta el uso de magnesio y lidocaína intravenosa en crisis dolorosas. Se requieren más estudios para justificar el uso de algunos coadyuvantes en dolor por cáncer.


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