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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2020, Número 5

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Acta Ortop Mex 2020; 34 (5)


Analgesia preventiva en pacientes sometidos a cirugía abierta por reparación del manguito rotador

Martínez-Domínguez JM, Quiroz-Williams J, Quíntela-Núñez del Prado H

Idioma: Español
Referencias bibliográficas: 37
Paginas: 272-275
Archivo PDF: 266.59 Kb.


RESUMEN

Introducción: La analgesia preventiva en cirugía ortopédica cada vez toma mayor importancia debido a que el control del dolor postquirúrgico es más grato para el paciente y le permite iniciar rehabilitación de forma temprana. Con esta premisa nos planteamos la siguiente hipótesis. La percepción del dolor postquirúrgico a las dos, 12 y 24 horas con infiltración local en la herida quirúrgica con ropivacaína más analgesia sistémica será menor en comparación con los pacientes que se infiltren con solución salina en la herida quirúrgica más analgesia sistémica. Material y métodos: Se realizó un ensayo clínico controlado aleatorizado doble ciego, prospectivo en el período comprendido de Enero de 2018 a Agosto de 2018. Resultados: Se rechazó la hipótesis nula en el grupo valorado a las dos horas y se aceptó la hipótesis nula en los grupos valorados a las 12 y 24 horas. Conclusión: La infiltración con ropivacaína es un método efectivo para el manejo del dolor postoperatorio durante las primeras dos horas en procedimientos de cirugía abierta de hombro.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Amiri HR, Mirzaei M, Taghi M, Mohammadi B, Tavakoli F. Multi-modal preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery: a randomized clinical trial. Anesth Pain Med. 2016; 6 (4): e33526. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099949/pdf/aapm-06-04-33526.pdf.

  2. Brunicardi FC, Schwartz SI. Schwartz’s principles of surgery. 8th ed. New York; London: McGraw-Hill; 2005.

  3. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006; 367(9522): 1618-25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16698416.

  4. Macrae WA. Chronic pain after surgery. Br J Anaesth. 2001; 87(1): 88-98. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11460816.

  5. Amruta VD, Rupesh T. Utilization of analgesics in perioperative cases of teaching hospital. Int J Med Pharm Sci. 2013; 3(6): 14-9. Available from: http://www.scopemed.org/?mno=34155.

  6. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97(2): 534-40, table of contents. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12873949.

  7. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014; 30(1): 149-60. Available from: http://www.tandfonline.com/doi/full/10.1185/03007995.2013.860019.

  8. Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature. 1983; 306(5944): 686-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6656869.

  9. Hariharan S, Moseley H, Kumar A, Raju S. The effect of preemptive analgesia in postoperative pain relief. A prospective double-blind randomized study. Pain Med. 2009; 10(1): 49-53. Available from: https://watermark.silverchair.com/10-1-49.pdf?token=AQECA Hi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485 ysgAAAdwwggHYBgkqhkiG9w0BBwagggHJMIIBxQIBADCCA b4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMnpcje APyqIIOmH6_AgEQgIIBj3WyYmv3URV38EOHhXguD4oPubguRu 7blqef1uPzBEeeBki

  10. Carr DB, Goudas LC. Acute pain. Lancet. 1999; 353(9169): 2051-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10376632.

  11. Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001; 413(6852): 203-10. Available from: http://www.nature.com/doifinder/10.1038/35093019.

  12. Gandhi K, Viscusi E. Multimodal pain management techniques in hip and knee arthroplasty. J New York Sch Reg Anesth. 2009; Available from: https://www.nysora.com/files/2013/pdf/(v13p1-10)MultimodalPainManagement.pdf.

  13. Eidy M, Fazel MR, Janzamini M, Haji RM, Moravveji AR. Preemptive analgesic effects of transcutaneous electrical nerve stimulation (TENS) on postoperative pain: a randomized, double-blind, placebo-controlled trial. Iran Red Crescent Med J. 2016; 18(4): e35050. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27275401.

  14. Markham A, Faulds D. Ropivacaine. A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs. 1996; 52(3): 429-49. Available from: http://link.springer.com/10.2165/00003495-199652030-00012.

  15. Pettersson N, Emanuelsson BM, Reventlid H, Hahn RG. High-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair: a clinical and pharmacokinetic evaluation. Reg Anesth Pain Med. 1998; 23(2): 189-96. Available from: http://journals.lww.com/rapm/pages/articleviewer.aspx?year=1998&issue=23020&article=00013&type=abstract

  16. Clayton RAE, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008; 39(12): 1338-44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19036362.

  17. Piitulainen K, Ylinen J, Kautiainen H, Häkkinen A. The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear. Disabil Rehabil. 2012; 34(24): 2071-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22494417.

  18. Arenas PA, Ortega AJ, Arenas MA, Ayala PH, Garbayo MA. Impingement syndrome with rotator-cuff tears. Treatment and prognosis. 2005; 40(224): 159-69. Available from: http://www.cirugia-osteoarticular.org/adaptingsystem/intercambio/revistas/articulos/171_159.pdf.

  19. Amiri HR, Mirzaei M, Taghi M, Mohammadi B, Tavakoli F. Multi-modal preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery: a randomized clinical trial. Anesth Pain Med. 2016; 6 (4): e33526. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099949/pdf/aapm-06-04-33526.pdf.

  20. Brunicardi FC, Schwartz SI. Schwartz’s principles of surgery. 8th ed. New York; London: McGraw-Hill; 2005.

  21. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006; 367(9522): 1618-25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16698416.

  22. Macrae WA. Chronic pain after surgery. Br J Anaesth. 2001; 87(1): 88-98. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11460816.

  23. Amruta VD, Rupesh T. Utilization of analgesics in perioperative cases of teaching hospital. Int J Med Pharm Sci. 2013; 3(6): 14-9. Available from: http://www.scopemed.org/?mno=34155.

  24. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97(2): 534-40, table of contents. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12873949.

  25. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014; 30(1): 149-60. Available from: http://www.tandfonline.com/doi/full/10.1185/03007995.2013.860019.

  26. Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature. 1983; 306(5944): 686-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6656869.

  27. Hariharan S, Moseley H, Kumar A, Raju S. The effect of preemptive analgesia in postoperative pain relief. A prospective double-blind randomized study. Pain Med. 2009; 10(1): 49-53. Available from: https://watermark.silverchair.com/10-1-49.pdf?token=AQECA Hi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485 ysgAAAdwwggHYBgkqhkiG9w0BBwagggHJMIIBxQIBADCCA b4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMnpcje APyqIIOmH6_AgEQgIIBj3WyYmv3URV38EOHhXguD4oPubguRu 7blqef1uPzBEeeBki

  28. Carr DB, Goudas LC. Acute pain. Lancet. 1999; 353(9169): 2051-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10376632.

  29. Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001; 413(6852): 203-10. Available from: http://www.nature.com/doifinder/10.1038/35093019.

  30. Gandhi K, Viscusi E. Multimodal pain management techniques in hip and knee arthroplasty. J New York Sch Reg Anesth. 2009; Available from: https://www.nysora.com/files/2013/pdf/(v13p1-10)MultimodalPainManagement.pdf.

  31. Eidy M, Fazel MR, Janzamini M, Haji RM, Moravveji AR. Preemptive analgesic effects of transcutaneous electrical nerve stimulation (TENS) on postoperative pain: a randomized, double-blind, placebo-controlled trial. Iran Red Crescent Med J. 2016; 18(4): e35050. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27275401.

  32. Markham A, Faulds D. Ropivacaine. A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs. 1996; 52(3): 429-49. Available from: http://link.springer.com/10.2165/00003495-199652030-00012.

  33. Pettersson N, Emanuelsson BM, Reventlid H, Hahn RG. High-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair: a clinical and pharmacokinetic evaluation. Reg Anesth Pain Med. 1998; 23(2): 189-96. Available from: http://journals.lww.com/rapm/pages/articleviewer.aspx?year=1998&issue=23020&article=00013&type=abstract

  34. Clayton RAE, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008; 39(12): 1338-44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19036362.

  35. Piitulainen K, Ylinen J, Kautiainen H, Häkkinen A. The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear. Disabil Rehabil. 2012; 34(24): 2071-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22494417.

  36. Arenas PA, Ortega AJ, Arenas MA, Ayala PH, Garbayo MA. Impingement syndrome with rotator-cuff tears. Treatment and prognosis. 2005; 40(224): 159-69. Available from: http://www.cirugia-osteoarticular.org/adaptingsystem/intercambio/revistas/articulos/171_159.pdf.




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