Guido-Guerra RE

Idioma: Español
Referencias bibliográficas: 30
Paginas: 229-231
Archivo PDF: 136.86 Kb.

RESUMEN

La analgesia epidural ha mostrado ser superior a la parenteral en cirugía abierta de abdomen, tórax y miembros pélvicos. Además del control de dolor, la analgesia epidural ha mostrado mejorar otros desenlaces como complicaciones respiratorias, intestinales, cardíacas y vasculares. El epidural torácico es preferible al lumbar en cirugía de tórax y abdomen. La inserción del catéter recomendada es de 5 cm a partir de la distancia a la que se identifica el espacio epidural. Se recomienda utilizar soluciones combinadas de anestésico local (bupivacaína, ropivacaína o levobupivacaína) y opioide. La analgesia intratecal con morfina provee buen control de dolor en el corto plazo. Sin embargo, se asocia con mayor incidencia de depresión respiratoria que la administración intravenosa del opioide.

REFERENCIAS (EN ESTE ARTÍCULO)

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