medigraphic.com
ISSN 1726-6718 (Electronic)
Revista Cubana de Anestesiología y Reanimación

2013, Number 2

<< Back Next >>

Revista Cubana de Anestesiología y Reanimación 2013; 12 (2)

Postoperative analgesia with the use of lyophilized morphine

Cruz DS, Ramos PLY, de la Cruz SI, Campos GM

Language: Spanish
References: 22
Page: 129-138
PDF size: 63.13 Kb.


ABSTRACT

Background: anesthesia with subarachnoid Morphine is not very used to alleviate acute postoperative pain during either elective or emergency surgical interventions.
Objective: to describe cardiorespiratory repercussion of anesthesia with subarachnoid Morphine in patients who have undergone surgery.
Methods: a longitudinal prospective descriptive study was conducted in a random sample of 500 patients who underwent surgery in the Surgical Service of Military Hospital of Holguín during the period from August 2009 to October 2012, who received subarachnoid anesthesia with 150 mg of hyperbaric lidocaine and 0.4 mg of lyophilized morphine. Variables such as systolic and diastolic blood pressures, cardiac frequency, respiratory frequency, oxygen saturation of hemoglobin, intensity of postoperative pain, time of postoperative analgesia, doses of rescue analgesia and adverse effects were monitored.
Results: The mean time of postoperative analgesia was prolonged to more than 30 hours and the majority of patients didn't demand rescue analgesia during the first 48 hours. Pruritus, nausea, and vomiting predominated as adverse effects.
Conclusions: The significant extension of analgesia with scarce demand of rescue analgesia and a stable cardiorespiratory behavior with an incidence of minor adverse effects convert anesthesia with subarachnoid Morphine into a useful and safe method for patients who have undergone either elective or emergency surgery.


REFERENCES

  1. Collins VJ. Historia de la Anestesiología. En: Anestesiología. 2da ed. La Habana: Editorial Científico-Técnico; 1984. p.2-15.

  2. Muñoz AL. Breve historia de la Anestesia. En: Muñoz AL, Herrera O, Rodríguez J. Manual de Anestesiología. Santiago de Chile: Editorial Universitaria; 1994. p.13-21.

  3. Morgan GE. Práctica en Anestesiología. En: Morgan GE, Mikhail M. Anestesiología Clínica. 2da ed. México: El Manual Moderno; 1998. p.3-16.

  4. León A. Morfínicos Epidurales e Intratecales, nueva alternativa en el manejo del dolor. Actualización en Anestesia 1982; 4 (4): p.92-126.

  5. Montañez E. Evolución Histórica de la Anestesia Regional. Rev Española Anestesiología y Reanimación 1979; 25(3):163-79.

  6. Rodríguez VM, Saínz CH, Fleitas SC. Historia de la Anestesia. En: Dávila CE, Gómez BC, Álvarez BM, Saínz CH, Molina LR. Anestesiología Clínica. 2ª ed. Ciudad de La Habana: Editorial Ciencias Médicas; 2006. p.1-32.

  7. Brill S, Gurman GM, Fisher A. A history of neuroaxial administration of local analgesics and opioids. Eur J Anesthesiology 2008; 21 (4): 329-30.

  8. Siddall PJ, Cousins MJ. Neurobiology of pain. International Anesthesiology Clinics 2006; 35 (2):p. 1-26.

  9. WHO, Global burden of disease attributable to injuries, 2010 estimates. In World Health Report. World Health Organization, Geneva. 2010.34-38.

  10. Krug EG. World report on Violence and Health. World Health Organization, Geneva 2008:p.124-132.

  11. Health Situation in the Americas. Basic Indicators. Washington, Pan American Health Organization, 2010.p.1-6.

  12. Principales causas de muerte de todas las edades. Anuario estadístico de Salud 2010. Disponible en: http://www.sld.cu/sitios/.

  13. Slover RB, Gates RA. Tratamiento del dolor agudo. En: Duke J, Rosemberg SG. Secretos de la anestesia. México: McGraw-Hill Interamericana; 2010. p. 441-8.

  14. Chandrasekhar S, Pian-Smith M. Spinal, Epidural and Caudal Anesthesia. En: Hurford EW, Bailin TM, Davison JK, Haspel LK, Rosow C, Vasallo SA. Clinical Anesthesia Procedures of the Massachusetts General Hospital. 6ta ed. Madrid: Marban Libros; 2006. p. 242-63.

  15. David L, Brown C. Spinal, Epidural, and Caudal Anesthesia. En: Miller RD, Cuchiara RF, Miller ED, Reves G, Roisen MF, Savarese JJ et al. Anesthesia. 5ta ed. New York: Churchil Livingstone; 2010. p. 1491-1518.

  16. Tetzlaff JE. Bloqueo raquídeo, epidural y caudal. En: Morgan GE, Mikhail M. Anestesiología Clínica. 2da ed .México: El Manual Moderno; 1998. p.249-87.

  17. Catterall W, Mackie K. Anestésicos Locales. En: Hardman JG, Linbird LE, Goodman Gilman A. Las bases farmacológicas de la terapéutica. 10ma ed. México: Mc Graw-Hill Interamericana; 2008. p.375-91.

  18. Tetzlaff JE. Bloqueo raquídeo, epidural y caudal. En: Morgan GE, Mikhail M. Anestesiología Clínica. 2da ed .México: El Manual Moderno; 1998. p.249-87.

  19. Flórez J. Fármacos y dolor. [monografía en Internet]. Madrid: Ergon; 2004. [consultada 21 septiembre 2012]. Disponible en: http://www.todoparacetamol.info/profesionales/publicaciones/pdf_libros/.

  20. Hunter M, Rowson T, Lewis W. Hemodilution in regional anesthesia. Minerva Anestesiol 2008; 69: p.45-53.

  21. Bustos TM, Estévez IA, Gallego GJ, Mayo MM. Estudio comparativo la eficacia analgésica del tramadol versus morfina-metamizol tras histerectomía abdominal. Sociedad española del dolor. Salamanca: Sociedad de Dolor; 2002. Disponible en: http://www.sedolor.es/congreso.php?anno=2002&contenido=16

  22. La agenda del anestesiólogo. Morfina. [monografía en Internet]. AnestNet. [consultada 12 octubre 2012]. Disponible en: http://www.uam.es/departamentos/medicina/anestnet/agenda/farmacología/morfina.htm#farmacología.




2020     |     www.medigraphic.com