2012, Number 3
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Rev Cub Med Mil 2012; 41 (3)
Multimodal analgesia for postoperative pain in patients undergoing emergency appendectomy
Rosa DJ, Echazabal MJ, Navarrete ZV
Language: Spanish
References: 12
Page: 262-270
PDF size: 98.52 Kb.
ABSTRACT
Introduction: acute pain is common among patients with disorders requiring emergency surgery, and its relief is one of the greatest challenges in such circumstances. Multimodal postoperative pain relief therapy has proven to be more effective than the use of a single analgesic.
Objective: compare the use of multimodal analgesia with analgesic monotherapy for the management of postoperative pain in patients undergoing emergency appendectomy.
Methods: a comparative study was conducted of 40 patients randomly distributed into two groups, each composed of 20 patients. After the induction of analgesia, patients in Group I received intravenous dipyrone, and those in Group II additionally received tramadol and ketamine. The following parameters were observed: quality of analgesia, need of rescue analgesia, complications and adverse effects.
Results: pain intensity was lower in Group II. Rescue analgesia was required only in Group I. The adverse effects were nausea, vomiting and dizziness in Group I. No complications occurred in the study groups.
Conclusions: multimodal analgesia is more effective than analgesic monotherapy as a method to control postoperative pain in patients undergoing emergency appendectomy.
REFERENCES
Paeile C, Saavedra H. El dolor. Aspectos básicos y clínicos. Santiago de Chile: Editorial Mediterráneo;1990. p. 87-101.
Cordero EI, Abela LA, Martínez MO, López AA. Dolor postoperatorio: Eficacia del tramadol en la analgesia preventiva. Rev Inv Méd Quir. 2002;1(2):19-25.
Guevara V, Roa L. Consideraciones fisiopatológicas sobre el dolor agudo y crónico. Med Periop. 1997;1(1):17-25.
Reid RI. Acute postoperative pain management a review . Can J Urol. 2001;8:1394-400.
Cánovas ML, Barros CN, Pombo AG, González DG, Castro MB, Castro AM. Eficacia analgésica de la asociación ketamina + morfina epidural: experiencia en 75 casos. Rev Soc Esp Dolor. 2005;9:140-5.
Elena G, Amerio N, Ferrero P, Bay ML, Valenti J, Colucci D, et al. Effects of repetitive sevoflurane anaesthesia on immune response, select biochemical parameters and organ histology in mice. Lab An. 2005;37(3):193-203.
Wuesten R, Van H, Glass P, Buerkle H. Assessment of Depth of Anesthesia and Postoperative Respiratory Recovery after Remifentanil- versus Alfentanil-based Total Intravenous Anesthesia in Patients Undergoing Ear-Nose-Throat Surgery Anesth. 2001;94:211-7.
Labrada A, Jiménez-García Y. Preventive multimodal analgesia: a comparative study. Rev Soc Esp Dolor. 2004;11:122.
Puentes AC, Rodelo KA, Medina DP, Sánchez AM. Efecto de adicionar ketamina a la morfina en analgesia controlada por el paciente (pca) en un modelo de laparotomía. Rev Col Anest. 2008;36:19-24.
González SF. Ketamina epidural. Realidad y controversia. Rev Cubana Anest Rean. 2004;3(3):36-42.
Abreu SF, Navarrete ZV, Menéndez BV, Rodríguez MS, Fdez MB, de Armas LC. Midazolam-ketamina-propofol vs. propofol para sedación en resonancia magnética nuclear. Costos y beneficios. Rev Cubana Anest Rean. 2007;6(2):20-33.
Cabreras MC, Trujillo M, Cusmille MA. Ketamina endovenosa preoperatorio mejora la analgesia postoperatoria de colecistectomías laparoscópicas. Boletín El Dolor. 2006;15:8-12.