medigraphic.com
ISSN 1028-4818 (Electronic)

2019, Number 1

<< Back Next >>

Mul Med 2019; 23 (1)

Post-operative analgesia with intrathecal morphine in proctologic surgery

Tarancón SIA, Ferrer FAM

Language: Spanish
References: 15
Page: 22-33
PDF size: 453.48 Kb.


ABSTRACT

Introduction: postoperative pain is the most frequent complaint of patients who have undergone surgery, it is not the "forced" result of an intervention, but of an insufficient analgesia; When this is assumed by anesthesiologists in a stable and structured way, the use of local anesthetics and analgesics is more rational and effective, not only because of greater knowledge of them, but also because the most effective administration routes are increased.
Objective: to determine the benefits of the use of intrathecal morphine in surgical proctology patients.
Method: an observational, descriptive, longitudinal, retrospective study was carried out in the period from January 1 to June 30, 2017. The sample consisted of 50 patients with anus rectal affections, to whom regional morphine anesthesia was applied. intrathecal We excluded patients with chronic painful pathologies, known hypersensitivity to the medication and / or local anesthetics and contraindications for spinal anesthesia. The data was processed by numbers and percents.
Results: patients aged 31-40 years (46%), male sex, predominated in the study; (58%), the common adverse effects were pruritus, (20%), and nausea/vomiting; (8%).
Conclusions: good analgesia was achieved with prolongation of up to 20 hours in the majority of patients with very low frequency of adverse effects.


REFERENCES

  1. Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth 2014; 7: 17-22.

  2. Zaslansky R, Routhaug J, Chapman CR, Backström R, Brill S, Engel C, et al. PAIN OUT: the making of an international acute pain registry. Eur J Pain 2015; 19(4): 490-502.

  3. Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, et al. Improvingthemanagement of postoperativeacutepain: prioritiesforchange. CurrMed Res Opin. 2015;31(11):2131-243.

  4. Hernández Hernández L, Ramirez Bermejo A, Peña Riverón A, Gordillo Álvarez V. Analgesia Postoperatoria Basada en Protocolos. Revista Mexica de Anestesiología 2017; 40(Supl 1):s233-s235.

  5. 5.Chou R, Gordon DB, de León-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: a clinical practice guide line from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committeeon Regional Anesthesia, Executive Committee, and Administrative Council. J Pain 2016;17(2):131-157.

  6. Misiołek H, Cettler M, Woroń J, Wordliczek J, Dobrogowski J, Mayzner- Zawadzka E. The 2014 guide lines for post-operative pain management. Anaesthesiol Intensive Ther. 2014;46(4):221-244.

  7. Malavera LA, Carrillo S, Gomezese OF. Fisiopatología y tratamiento del dolor de miembro fantasma. Rev Colomb Anestesiol 2014;42(1): 40-46.

  8. Fernández-Dueñas V, Poveda R, Fernández A, Sánchez S, Planas E, Ciruela F. Fentanyl-trazodone-paracetamol triple drugcombination: multimodal analgesia in a mouse model of visceral pain. Pharmacol Biochem Behav 2011;98(3):331-336.

  9. Wiffen PJ, McQuay HJ, Edwards JE, Moore RA. Gabapentina para el dolor agudo y crónico. Bib Cochrane Plus [Internet]. 2008 [citado 20/8/2018]. Disponible en: http://www.fisterra.com/guias2/cochrane/AB005452-ES.htm

  10. 10.Voscopoulos C, Lema M. When does acute pain become chronic? Br J Anaesth 2010;105(supl 1):i69-85.

  11. Rosa-Díaz J, Navarrete Zuazo V, Díaz Mendiondo M. Aspectos básicos del dolor postoperatorio y la analgesia multimodal preventiva. Revista Mexicana de Anestesiología 2014; 37(1): 18-26.

  12. Orizondo Pajón SA, Caignet Abelardo M, Morúa-Delgado V, Salgado Betancourt J, Falcón Guerra M. Analgesia postoperatoria con morfina intratecal en cirugía proctológica. Rev Cubana Anestesiol Reanimación 2011; 10(2): 135-43.

  13. Matsuda M, Ueki R, Murakawa K, Sasaki K, Boo K, Tashiro C. Low doseintratecalmorphine and post-operative pain relief in elderly patients. Masui 2001; 50(10): 1096-100.

  14. Vara A, Muñoz Zurdo M, Sastre JA, Sánchez FJ. Efectos adversos de los opioides. Rev Soc Esp Dolor 1999;6(supl4):82-9411.

  15. Rathmell J P, Pino C A, Taylor R, Patrin T, Viani B A. Intra the calmorphine for postoperative analgesia: a randomized, controlled, dose-rangingstudyafter hip and kneearthroplasty. Anaesth y Analg 2003;97(5): 1452-7.




2020     |     www.medigraphic.com