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

2018, Number 2

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Revista Cubana de Anestesiología y Reanimación 2018; 17 (2)

Thoracic epidural analgesia for the relief of postoperative pain in thoracic surgery

Sánchez TM, García RE, Sánchez MML, Cruz CM

Language: Spanish
References: 21
Page: 10-20
PDF size: 259.28 Kb.


ABSTRACT

Introduction: Postoperative pain is a phenomenon that appears frequently and constitutes one of the most important challenges in the surgical field.
Objective: To describe the clinical and hemodynamic results obtained with the use of high thoracic epidural as analgesic technique during the postoperative period in patients undergoing thoracic surgery.
Method: A descriptive, longitudinal, prospective study was carried out in "Abel Santamaría Cuadrado" Hospital, during the period between January 2014 and January 2017. The sample consisted of 37 patients who met the inclusion and exclusion criteria.
Results: In blood pressure and heart rate according to analgesic response, normal values prevailed in those without postoperative pain, with 33 ± 5.23 and 33 ± 7.86 respectively. A mean of oxygen saturation of 99.48 % and respiratory rate of 16 res/min were calculated. It was evidenced that 31 patients (83.78 %) did not present postoperative complications after the analgesic technique. In the majority, rescue analgesia was not necessary, an element that represented 89.19 %. It was significant that 32 patients (86.49 %) said they were satisfied with the procedure and the results achieved.
Conclusions: The application of peridural with morphine for thoracic surgery yielded very effective results as an analgesic method with adequate stability, minimal complications and analgesic rescue requirements, which led to patient satisfaction.


REFERENCES

  1. Covarrubias Gómez A. Dolor postoperatorio. En: Carrillo Esper R. Tópicos selectos en anestesiología. México: Editorial Abril; 2008. p. 291-302.

  2. Slover R, David HR. Tratamiento del dolor agudo. En: James Duke. Anestesia: Secretos. 4ta ed. España: Editorial Elsevier; 2011. p. 527-34.

  3. Loeser John D. Cuestiones actuales en el manejo del dolor. En: Von Roenn Jaime H, Paice Judith A, Preodor Michael E. Diagnóstico y tratamiento del dolor. México: McGraw-Hill; 2008. p. 1-8.

  4. Covarrubias Gómez A, Guevara López U. Evaluación y alivio del dolor postoperatorio. En: Carrillo Esper R. Evaluación y manejo perioperatorio. México: Editorial Abril: 2012. p. 111-21.

  5. Hernández L, Gordillo Álvarez V, Peña Riverón A, Torres Méndez R, Ramírez Bermejo A. Taller Teórico-Práctico «Analgesia postoperatoria basada en protocolos». Rev Mex Anestesiol. 2016 [citado 19 dic 2016];39(1):194-96. [aprox. 3 p.]. Disponible en: http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eae7e9d9-9505-4bfcbc99-91501e2a5ee3%40sessionmgr4009&vid=0&hid=4206

  6. Hurley Robert W, Wu Christopher L. Dolor postoperatorio agudo. En: Miller R. Miller Anesthesia. 8va ed. España: Editorial Elsevier; 2016. p. 2523-45.

  7. Berde CB, Strichartz GR. Anestésicos locales. En: Miller R. Miller Anesthesia. 8va ed. España: Editorial Elsevier; 2016. p. 1028-53.

  8. Malamed SF. Anestesia local. 6ta ed. España: Editorial Elsevier; 2013. p. 1-75.

  9. Genové M, Santeularia T, Revuelta ME. Dolor postoperatorio. En: Catalá E, Ferandiz M, Genové M, editores. Manual de tratamiento del dolor. 2da ed. Barcelona: Publicaciones Permanyer; 2008. p. 204-39.

  10. Pías Solís S, Armas Pedrosa G, Alfonso Puentes N, López Rabasa S, González Rodríguez GS. Analgesia epidural torácica en pacientes con fracturas costales múltiples. AMC. 2006 [citado 21 ago 2017];10(2):87-95. [aprox. 8 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S102502552006000200009&lng=es

  11. Vaca Damy A, Villaseñor Santillán L, Ríos Alatorre AA, Ramírez Ruiz M, Hernández Gutiérrez D, Valdez S. Dexmedetomidina más bupivacaína frente a bupivacaína sola en infusión peridural para el control del dolor postquirúrgico. Rev Mex Neurocirug. 2011 [citado 23 feb 2017];12(4):181-86. [aprox. 7 p.]. Disponible en: http://www.medigraphic.com/pdfs/revmexneu/rmn-2011/rmn114d.pdf

  12. Velázquez González K, Valdés Llerena R, Pérez Guirola Y. Analgesia postoperatoria en cirugía torácica electiva. Rev cuba anestesiol reanim. 2010 [citado 19 dic 2016];9(2):107-18. [aprox. 11 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S172667182010000200006&lng=es

  13. Seguras LLanes O, Echevarría Hernández AT, Hernández Luaces LF, Fitó Fernández K. Opioides epidurales asociados a bupivacaína para analgesia postoperatoria en gestantes preeclámpticas cesareadas. Rev Cuba Anestesiol Reanim. 2014 [citado 19 dic 2016];13(2):105-14. [aprox 9 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S172667182014000200002&lng=es

  14. Brito Guraieb G, Jaqueline Xospa-Alemán T. Eficacia de la analgesia epidural en bolo con bupivacaína-fentanyl en pacientes sometidos a cirugía abdominal. Rev Mex Anestesiol. 2015 [citado 21 ago 2017];38(4):230-38. [aprox. 8 p.]. Disponible en: http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=5470c69e-13b24d1c-aefb-9088f8b70c22%40sessionmgr103

  15. Velazco Morera R, Campos Perdomo LM, González Pérez E, Águila Soto PC, Nieto Monteagudo CG, González Cabrera N. Efectividad de la analgesia anticipatoria con morfina epidural en la cirugía torácica electiva. Acta Médica del Centro. 2016 [citado 9 oct 2017];5(2):23-29. [aprox. 6 p.]. Disponible en: http://revactamedicacentro.sld.cu/index.php/amc/article/view/566

  16. Cujiño I, Velásquez M, Ariza F, Loaiza J. Awake epidural anesthesia for thoracoscopic pleurodesis: A prospective cohort study. Rev Colomb Anestesiol. 2013 [citado 21 ago 2017];41(1):10-15. [aprox. 6 p.]. Disponible en: http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=10808b8b-ba054c6d-b8dd-c4f98b0ee608%40sessionmgr101

  17. Holler J, Ahlbrandt J, Gruß M, Hecker A, Weigand M, Röhrig R. The effect of peridural analgesia on long-term survival after surgery in patients with colorectal cancer: A systematic meta-analysis. Der Chirurg; Zeitschrift Fur Alle Gebiete der Operativen Medizen. 2015 [citado 21 ago 2017];86(7):655-61. [aprox. 6 p.]. Disponible en: http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=c19b7fcd-cf7b4851-b953-c2362a4927a8%40sessionmgr101

  18. Ortega R, Alfonso O, Hidalgo Menéndez P, Font I, Rodríguez J, Martínez M, et al. Eficacia analgésica postoperatoria de la morfina epidural en la cirugía de revascularización miocárdica. Corsalud. 2011 [citado 19 dic 2016];3(1):15-25. [aprox. 10 p.]. Disponible en: http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=57694179-d7b8-4699b774-1fb61feac347%40sessionmgr4008&vid=0&hid=4206

  19. de Pontes Jardim A, Rolf Erdmann T, Viçoso dos Santos T, Muriano Brunharo G, Bevilacqua Filho CT, Joaquim Losso M, et al. Comparison between continuous thoracic epidural and paravertebral blocks for postoperative analgesia in patients undergoing thoracotomy: systematic review. Rev Bras Anestesiol. 2013 [citado 19 ene 2017];63 (5):433-42. [aprox. 9 p.]. Disponible en: http://ac.elscdn.com/S0104001413001735/1-s2.0-S0104001413001735-main.pdf?_tid=f2342f8acd2d-11e6-98d8-00000aab0f01&acdnat=1482950970_52cc7bf77740001c35e99f188e213f6b

  20. Acosta Martínez J, González Rubio D, López-Herrera Rodríguez D, Villegas Duque D. Alternativas de analgesia loco regional en el trasplante hepático. AnestesiaR. 2014 [citado 19 ene 2017];63(5):433-42. [aprox. 9 p.]. Disponible en: http://anestesiar.org/2014/alternativas-de-analgesia-locorregional-en-el-trasplantehepatico/

  21. Yeung JH, Gates S, Naidu BV. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Data base Syst Rev. 2016; CD009121.




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