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>Revistas >Cirugía y Cirujanos >Año 2013, No. 5

Evaristo-Méndez G, García de Alba-García JE, Sahagún-Flores JE, Ventura-Sauceda FA, Méndez-Ibarra JU, Sepúlveda-Castro RR
Eficacia analgésica de la infiltración incisional de ropivacaína vs ropivacaína con dexametasona en la colecistectomía laparoscópica electiva
Cir Cir 2013; 81 (5)

Idioma: Español
Referencias bibliográficas: 40
Paginas: 383-393
Archivo PDF: 471.97 Kb.

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Antecedentes: el dolor incisional es el principal obstáculo para la colecistectomía laparoscópica electiva ambulatoria.
Objetivo: evaluar la eficacia analgésica de la infiltración local de ropivacaína con dexametasona (Rop/Dx) en comparación con ropivacaína (Rop) sola, durante las primeras 24 horas del postoperatorio de esta cirugía.
Material y métodos: ensayo clínico aleatorizado, controlado y doble ciego, efectuado en 80 pacientes que para fines de estudio se dividieron en dos grupos. El grupo Rop (n= 40) recibió infiltración pre y post-incisional con 150 mg de ropivacaína en 8 mL de solución salina 0.9%, mientras que el grupo Rop/Dx (n= 40) recibió 150 mg de ropivacaína con 8 mg de dexametasona en 6 mL de solución salina 0.9%. La intensidad del dolor durante el reposo y el movimiento se evaluó a las 2, 4, 8, 12 y 24 horas del postoperatorio con una escala de clasificación numérica de 11 puntos. La hipótesis es que la intensidad del dolor incisional será menor en los pacientes del grupo Rop/Dx.
Resultados: las puntuaciones del dolor incisional en el grupo Rop/Dx fueron significativamente menores, comparadas con el grupo Rop, a las 12 horas (p= 0.05) y 24 horas (p= 0.01) durante el reposo y a las 12 horas (p= 0.04) y 24 horas (p= 0.01) durante el movimiento postoperatorio.
Conclusiones: la evidencia inicial es que la ropivacaína con dexametasona, por infiltración local, disminuye la intensidad del dolor incisional a partir de las 12 horas post-colecistectomía laparoscópica electiva con un buen perfil de seguridad.

Palabras clave: colecistectomía laparoscópica, dolor incisional, dexametasona.


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>Revistas >Cirugía y Cirujanos >Año2013, No. 5

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