ABSTRACT
Objetivo: Analizar el control del dolor en el postoperatorio inmediato del servicio en servicio de cirugía en el servicio de cirugía del Hospital Docente Ambato Ecuador. Método: Descriptiva observacional en 99 pacientes quirúrgicos. Resultados: 52% de pacientes intervenidos quirúrgicamente se les diagnóstico una apendicitis aguda, seguido por la litiasis vesicular como patología quirúrgica con un 37, 4 % de representatividad. Conclusión: Para el bienestar del paciente es necesario el uso de medidas analgésicas frente a la consecuencia del acto quirúrgico, que es el dolor, se obtienen resultados positivos mediante la administración de medicación intravenosa (IV), manejo ambiental: confort y la vigilancia usando estas como las medidas base en el control de estos pacientes.
Objective: To analyze pain control in the immediate postoperative period in the surgery service at the surgery service of the Hospital Docente Ambato - Ecuador. Methods: Descriptive observational study in 99 surgical patients. Results: 52% of patients who underwent surgery were diagnosed with acute appendicitis, followed by vesicular lithiasis as a surgical pathology with 37.4% of representativeness. Conclusion: For the well-being of the patient it is necessary the use of analgesic measures against the consequence of the surgical act, which is pain, positive results are obtained through the administration of intravenous (IV) medication, environmental management: comfort and surveillance using these as the basic measures in the control of these patients.
ABSTRACT
Introduction: Despite the enhancing effects of hyaluronidase (HYAL) over duration of anesthesia, this enzyme could cause adverse effects when injected concomitantly with local anesthetics in dental blocks. Objective: This study aimed to assess the tissue alterations caused by a local anesthetic protocol consisting of a late HYAL injection and confirm its functional effectiveness. Materials and Methods: The protocol efficacy was proved by evaluating sensory and motor functions in rats. The sciatic nerve was blocked with 2% lidocaine (LID) with epinephrine (n = 25). Thirty minutes later, 75 TRU/ml HYAL was injected into the same site (experimental group, LID/HYAL). One week later, this protocol was repeated in the contralateral hindlimb, injecting only HYAL's vehicle (control group, LID/vehicle [LID/V]). To observe the integrity of the local tissues, histological specimens were obtained 1, 24, 48, and 72 h after treatment with LID/HYAL or LID/V (n = 16 each) and stained with hematoxylin/eosin and picrosirius red. Results: Local inflammation was similar in both groups. The integrity of the nerve fibers was preserved, in spite of some inflammation-associated injuries in the surrounding tissues. The reversible tissue disorganization caused by HYAL, probably facilitated the diffusion of the residual anesthetic to the nerve, resulting in a prolonged anesthetic effect (P < 0.05). Conclusions: No irreversible morphological alterations are caused by the administration of HYAL prior the end of the LID-induced block. Moreover, this protocol prolongs LID's anesthetic effect.