miércoles, 24 de diciembre de 2014

Analgesia postcesárea/Postcesarean analgesia

Efecto de la infusión pre-emptiva de sulfato de magnesio sobre el alivio del dolor postoperatorio en cesárea electiva 

Effect of pre-emptive magnesium sulfate infusion on the post-operative pain relief after elective cesarean section.
Rezae M, Naghibi K, Taefnia AM.
Adv Biomed Res. 2014 Aug 19;3:164. doi: 10.4103/2277-9175.139127. eCollection 2014.
BACKGROUND:The aim of this study was to evaluate the analgesic efficacy of pre-operative single dose of intravenous (I.V.) magnesium sulfate infusion in patients undergoing elective Cesarean section. MATERIALS AND METHODS:Seventy pregnant women who underwent elective Cesarean section were randomly divided into two groups. Before induction of anesthesia, the magnesium group (Group A) received magnesium sulfate 50 mg/kg I.V. in bolus dose. The control group (Group B) received the same volume of isotonic saline. The pain scores at rest and also upon movement were evaluated up to 24 h post-operatively and analgesic requirement was recorded during the first 24 h after operation. RESULTS: Cumulative analgesic consumption (24 h after operation was 11.2 ± 6.3 mg in group A vs. 13.9 ± 3.9 mg in group B). Post-operative pain scores (24 h after operation was 1.8 ± 2.1 in group A vs. 2.9 ± 1.2 in group B) and shivering incidents (8.57 in group A vs. 14.28 in group B) were significantly lower in Group A (P < 0.05). Mean arterial pressure just after intubation and during the immediate post-operative period was significantly lower in Group A (P < 0.05). CONCLUSION: Pre-operative intravenous magnesium sulfate infusion decrease post-operation pain and requirement of analgesia in Cesarean section. KEYWORDS:Cesarean section; magnesium sulfate; post-operative pain

Comparación de la eficiencia analgésica entre la infiltración de la herida y el bloqueo TAP guiado con ultrasonido después de cesárea con anestesia espinal

Comparison of analgesic efficiency between wound site infiltration and ultra-sound-guided transversus abdominis plane block after cesarean delivery under spinal anaesthesia.
Aydogmus M, Sinikoglu S, Naki M, Ocak N, Sanlı N, Alagol A.
Hippokratia. 2014 Jan;18(1):28-31.
BACKGROUND: [corrected] Local anesthetic infiltration applied on the wound site or abdominal wall may be used for relieving postoperative pain after delivery by caesarean section. The aim of this study was to compare the analgesic efficiency of ultrasound (USG)-guided transversus abdominis plane (TAP) block with local anesthetic infiltration on a wound site. METHODS:This study was designed as a prospective randomized trial, and consisted of 70 pregnant women of American Society of Anesthesiologists (ASA) class I-II. Patients were randomized into Group I (wound site infiltration, n=35) and Group T (TAP block, n=35). Spinalanaesthesia was administered to all patients. In Group I, wound site infiltration was applied by the surgical team. In Group T, a USG-guided bilateral TAP block was applied. Patients' numeric pain scale (NPS) levels at 2, 6, 12 and 24(th) hours, after the operation (NPS0) and during mobilization were assessed. Postoperative complications, time to first analgesic request and patient satisfaction were recorded. RESULTS: The NPS0 values of Group T were found to higher and time to first analgesic request longer than those of Group I. The NPS values of Group I at 2, 6, 12, and 24(th) hours were found to be statistically significantly higher than those of Group T. CONCLUSIONS: According to our results, USG-guided TAP block might be superior to infiltration anaesthesia for postoperative pain management of patients who have had caesarean section and it provided longer-lasting and more efficient analgesia.
KEYWORDS: Ultrasound; cesarean section; infiltration anaesthesia; transversus abdominis plane block


Anestesiología y Medicina del Dolor

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