sábado, 16 de agosto de 2014

Analgesia postoperatoria/Postoperative analgesia

Efectividad de tramadol/paracetamol comparado con etoricoxib an analgesia postoperatoria para cirugía ambulatoria

Effectiveness of tramadol/paracetamol compared with etoricoxib as postoperative analgesia in daycare surgery
Choy Y. Choy and Adnan Isquandar
Southern African Journal of Anaesthesia and Analgesia 2014; 20(3):155-159
Objective: The objective was to evaluate the effectiveness of a fixed, tramadol/paracetamol combination when compared with etoricoxib as postoperative analgesia following day care surgery. Design: This was a prospective, randomised, single-blind study. Setting and subjects: Sixty-two patients were randomised to receive either etoricoxib (n = 29) or tramadol/paracetamol (n = 33) by mouth prior to surgery. Patients were given general anaesthesia with fentanyl for intraoperative and rescue analgesia. Outcome measures: The primary efficacy variables that were investigated were total pain relief and sum of pain intensity differences at 1, 2, 3, 4, 6, 24 and 48 hours. Data were collected by an independent observer through an interview or by telephone after discharge. Results: Total pain relief (p-value 0.001) was significantly different between the two groups for the first four hours. The total dose of fentanyl use was comparable between the two groups. There was also a significant difference in the occurrence of nausea with tramadol/paracetamol (p-value 0.001), and dizziness with etoricoxib (p-value 0.024). Conclusion: Tramadol/paracetamol provided significantly better pain relief than etoricoxib in the early postoperative period.
Keywords: daycare surgery, etoricoxib, paracetamol, postoperative analgesia, tramadol

Clonidina caudal en cirugía pediátrica ambulatoria

Caudal clonidine in day-care paediatric surgery.
Koul A1, Pant D, Sood J.
Indian J Anaesth. 2009 Aug;53(4):450-4.
SUMMARY:We evaluated the analgesic efficacy, hemodynamic and respiratory safety of Clonidine when added to bupivacaine for caudal block. Forty children undergoing inguinal hernia repair were randomly given caudal injection with 0.75 ml.kg(-1) of bupivacaine (0.25%) and clonidine 2 mug.kg(-1) in Group C or 0.75 ml.kg(-1) of bupivacaine (0.25%) alone in Group B after induction of anaesthesia. Postoperatively duration of analgesia, OPS score (observational pain / discomfort scale), Sedation score, heart rate and blood pressure were recorded. Duration of analgesia was significantly longer (p<0.001) in Group C (10.25 hours) as compared to 4.55 hours in Group B. Bradycardia, hypotension and sedation were not observed in Group C. The addition of Clonidine in caudal blocks prolongs postoperative pain relief in children and is safe alternative to bupivacaine alone in paediatric daycaresurgeries.
KEYWORDS: Bupivacaine; Caudal epidural; Clonidine


Analgesia multimodal en dolor postoperatorio

Multimodal Analgesia for the Management of Postoperative Pain
Borja Mugabure Bujedo1, Silvia González Santos1, Amaia Uría Azpiazu1, Anxo Rubín Noriega, David García Salazar1 and Manuel Azkona Andueza
Department of Anaesthesiology, Critical Care and Pain Medicine, Donostia University Hospital, San Sebastian, Spain


Anestesiología y Medicina del Dolor
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