Brito-Guraieb G, Xospa-Alemán TJ

Language: Spanish
References: 13
Page: 230-238
PDF size: 313.32 Kb.

ABSTRACT

Background: Postoperative epidural analgesia is the administration of local anesthetic with or without opioid in the epidural space to keep the individual free from pain. Method: clinical, comparative, controlled, prospective, randomized study, patients after hysterectomy and open cholecystectomy Tula Regional Hospital, the period from March to June 2013. 40 patients were selected without importing age, randomly distributed into five groups were selected depending on the concentration of bupivacaine administered by epidural catheter 0.120%, 0.130%, 0.150%, 0.170% and 0.20% more 50 µg fentanyl recovering, at 6, 12 and 24 hours, 20 minutes after administration of each dose was evaluated pain by visual analog scale, and vital signs were taken. Results: The concentrations of bupivacaine 0.120%, 0.130% and 0.150% more fentanyl 50 µg maintained patients had moderate pain, while 0.170% bupivacaine and 0.20% more fentanyl 50 µg remained without pain in patients throughout the study. Conclusions: Epidural analgesia bolus is effective in patients undergoing open abdominal surgery in hospitals with limited resources, accelerates recovery, reduces costs for the patient and the institution.

REFERENCES

1. Guevara-López U, de Lille-Fuentes R. Medicina del dolor y paliativa. México: Corporativo Intermédica; 2002.

2. Covarrubias-Gómez, Gaspar-Carrillo, Ayón-Villanueva, Zamora-Meráz, Mendoza-Reyes, Gutiérrez-Salmerón. Manual de apoyo avanzado en dolor agudo. Asociación Mexicana para el Estudio del Dolor; 2013.

3. Muñoz JM. Manual de dolor agudo postoperatorio. Madrid: Hospital Universitario La Paz; 2010.

4. Barash PG, Cullen BF, Stoelting RK. Anestesia clínica. 3a edición. Vol. 2. Nuevo México: McGraw-Hill Interamericana; 1999.

5. Guevara-López U, Covarrubias-Gómez A, Rodríguez-Cabrera R, Carrasco-Rojas A, Aragón G, Ayón-Villanueva H. Parámetros de práctica para el manejo del dolor en México. Cirugía y Cirujanos. 2007;75:385-407.

6. Jauregui-Flores LA, Tamariz-Cruz O, Zaragoza-Delgadillo JC. Manual de anestesiología del Instituto Nacional de Ciencias Médicas Salvador Zubirán. México: Manual Moderno; 2001.

7. Santeularia-Vergés MT, Puigbó EC, Cortada MG, Revuelta-Rizo M, Moral García MV. Nuevas tendencias en el tratamiento del dolor postoperatorio en cirugía general y digestiva. Cir Esp. 2009;86:63-71.

8. American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106:843-863.

9. Murphy JD, Gelfand HJ, Wu CL. Epidural opioids for postoperative pain. Elsevier; 2011.

10. Esteve-Pérez N, Del Rosario-Usoles E, Giménez-Jiménez I, Montero-Sánchez F, Baena-Nadal M, Ferrer A, et al. Seguridad y efectividad del tratamiento del dolor agudo postoperatorio: seguimiento de 3.670 pacientes. Rev Esp Anestesiol Reanim. 2008;55:541-547.

11. Machado de Oliveira R, Bernardo-Tenório S, Tanaka PP, Precoma D. Control del dolor por bloqueo epidural y aparición de arritmias cardíacas en el postoperatorio de procedimientos quirúrgicos torácicos y abdominales altos: estudio comparativo. Rev Bras Anestesiol. 2012;62:10-18.

12. Ramírez-Guerrero A, Calix-Perato E, Meneses-Sierra E, Burkle-Bonecchi J. Experiencia con buprenorfina epidural para control del dolor después de cirugía abdominal mayor. Rev Mex Anest. 1994;17:18-21.

13. Loaiza A, Valdespín R, Colín V, Zambada C, Dickters S, Genovés H. Infusión epidural de fentanyl/bupivacaína por medio de infusor elastomérico para el control del dolor postoperatorio. Rev Mex Anest. 1997;20:17-27.