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2011, Número 1

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CorSalud 2011; 3 (1)


Eficacia analgésica postoperatoria de la morfina epidural en la cirugía de revascularización miocárdica

Hernández OR, González AO, Hidalgo MPA, Marrero FIM, Rodríguez JM, Méndez MJ, García CS, González MM

Idioma: Español
Referencias bibliográficas: 56
Paginas: 15-25
Archivo PDF: 272.30 Kb.


RESUMEN

Introducción y objetivos: La analgesia epidural constituye un pilar básico en la cirugía cardíaca. El objetivo del estudio fue comparar el uso de la morfina liofilizada y la bupivacaína epidural en la analgesia postoperatoria para la cirugía de las arterias corona-rias. Método: Se realizó un estudio prospectivo e inferencial en 20 pacientes, divididos en dos grupos. Los del grupo M recibieron analgesia epidural con morfina 2 mg asociada a 100 mg de bupivacaína y los del grupo B solo bupivacaína. Resultados: Predominó el sexo masculino. Las edades y pesos promedio de ambos grupos fueron similares (p›0,05). El 90 % de los enfermos del grupo M tenían analgesia excelente a las 8 horas de la intervención, y se mantuvo entre buena y excelente a las 12 y 24 horas. Mientras que el 50 % de los pacientes del grupo B referían una analgesia regular a las 8 horas de operados, que se extendió al 80 % de los enfermos a las 12 horas. En el control de las 24 horas, la totalidad de los pacientes del grupo B se aquejaban de una analgesia insuficiente o mala (p ‹0,05). El tiempo total promedio de analgesia postoperatoria obtenida del grupo M fue de 28.37 horas y del grupo B, de 8.86 horas (p‹0,01). Los principales efectos adversos fueron la hipotensión arterial y la bradicardia. Conclusiones: La morfina demostró su utilidad como agente analgésico en la cirugía de las arterias coronarias. Los pacientes con bupivacaína y morfina epidural tuvieron mejor analgesia y por tiempos más prolongados que los enfermos tratados solo con bupivacaína.


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