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Introducción: La electroacupuntura induce la liberación de encefalina y b- endorfina. Objetivo: Evaluar la efectividad y seguridad de la electroacupuntura auricular para la analgesia posoperatoria en los pacientes electivos con diagnóstico quirúrgico de cáncer de piel. Métodos: Se realizó un estudio cuasi- experimental de intervención terapéutica en los pacientes electivos con diagnóstico de cáncer de piel, en el Hospital Provincial Docente de Oncología "María Curieˮ de Camagüey, en el período comprendido de enero de 2019 a enero de 2022. El universo fue de 200 pacientes, se constituyeron dos grupos, el grupo experimental integrado por 81 pacientes a los que se les aplicó electroacupuntura auricular preoperatoria y el grupo control formado por 119 pacientes a los que se les aplicó el tratamiento convencional. Resultados: Se observó predominio de la edad entre 55 a 59 años para ambos grupos de pacientes. Con la prueba estadística se planteó con un 95 % de confiabilidad que la intensidad del dolor posoperatorio cambio en relación al tratamiento empleado. La mayor parte de los pacientes tratados previamente con electroacupuntura auricular no presentó dolor en el posoperatorio (p = 0,000). El tratamiento impuesto guarda relación estadística significativa con la presencia de complicaciones posoperatorias relacionadas con el dolor, p ≤ 0,05. Se demostró la efectividad analgésica de la electroacupuntura (p = 0,000). Conclusiones: La electroacupuntura auricular para la analgesia posoperatoria en pacientes operados electivos de cáncer de piel, es eficaz y segura.
Introduction: Electroacupuncture induces enkephalin and b-endorphin release. Objective: To assess the effectiveness and safety of auricular electroacupuncture for postoperative analgesia in elective patients with a surgical diagnosis of skin cancer. Methods: A quasiexperimental study of therapeutic intervention was carried out in elective patients with skin cancer diagnosis, at María Curie Provincial Teaching Oncology Hospital of Camagüey, from January 2019 to January 2022. The study universe was two hundred patients. Two groups were made up: the experimental group, integrated by 81 patients, to whom preoperative auricular electroacupuncture was applied; and the control group, made up of 119 patients, to whom conventional treatment was applied. Results: Predominance of age between 55 and 59 years was observed for both groups of patients. The statistical test showed, with a reliability of 95 %, that the intensity of postoperative pain changed in relation to the used treatment. Most of the patients previously treated with auricular electroacupuncture did not present postoperative pain (p = 0.000). The employed treatment was statistically significant with respect to the presence of postoperative pain-related complications (p ≤ 0.05). The analgesic effectiveness of electroacupuncture was demonstrated (p = 0.000). Conclusions: Auricular electroacupuncture for postoperative analgesia in elective operated patients with skin cancer is effective and safe.
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HumanosRESUMEN
Introdução: O câncer de pele em cabeça e pescoço tem incidência crescente no mundo, sendo o carcinoma basocelular e espinocelular os tipos mais frequentes. Não existe consenso absoluto para todas as situações tumorais conforme tipo histológico, tamanho, profundidade e localização da lesão. O objetivo é analisar a conduta abordada nessas neoplasias de pele em cabeça e pescoço, com ênfase nos tratamentos efetuados, recidivas e seguimento. Método: Foram analisados 69 pacientes com carcinoma basocelular ou de células escamosas tratados por cirurgia com congelação da lesão no intraoperatório, crioterapia ou Imiquimod 5% por 6 semanas. Com 36 meses de seguimento, observou-se a eficácia do tratamento escolhido, recidiva, intercorrências, complicações e satisfação estética do paciente. A análise estatística utilizou o teste exato de Fischer. Resultados: O tipo de reconstrução mais frequente foi o fechamento primário (71%). Não existem associações estatisticamente relevantes relacionando idade, sexo, classificação de Fitzpatrick, local/ tamanho da lesão, métodos de tratamento e recidiva. As principais complicações resultaram das cirurgias: um caso de necrose de retalho frontal, lesão parcial de nervo bucinador, estenose narinária. A recidiva tumoral nos casos operados foi de 4%. A crioterapia e uso do Imiquimod 5% causaram seis casos de reações locais leves com mais recidiva descritiva no tratamento de carcinoma basocelular (CBC) superficial (não estatisticamente relevante). Conclusões: Os CBC não superficiais e carcinoma espinocelular devem ser tratados cirurgicamente. Os CBC superficiais podem ser tratados com crioterapia e uso do Imiquimod 5% com menos complicações e melhor resultado estético, mas a recidiva tumoral é maior.
Introduction: The incidence of skin cancer on the head and neck is increasing worldwide, and basal and squamous cell carcinomas represent the most frequent types. There is no unanimous consensus for all tumor cases, based on the histological type, size, depth, and location of the lesion. The objective is to analyzed the approach used in skin neoplasias in the head and neck, focusing on the treatments performed, recurrence, and follow-up. Methods: Sixty-nine patients with basal or squamous cell carcinoma who were treated with surgery, cryotherapy, freezing of lesions in the intraoperative period, or 5% imiquimod were analyzed for 6 weeks. During 36 months of follow-up, the efficacy of the chosen treatment, recurrence, side effects, complications, and esthetic satisfaction of patients were observed. Statistical analysis was performed using the Fisher's exact test. Results: The most frequent type of reconstruction was primary closure (71%). There were no statistically significant correlations between age, sex, Fitzpatrick classification, location/size of lesion, method of treatment, or recurrence. The main complications resulting from surgery were: a case of a frontal flap necrosis, a partial lesion of the buccinator nerve, and nasal stenosis. There was a 4% tumor recurrence in patients treated with surgery. The cryotherapy and 5% imiquimod treatments resulted in six cases of mild local reactions with a more pronounced recurrence in a patient with superficial basal cell carcinoma (BCC) (not statistically significant). Conclusions: Non-superficial BCC and squamous cell carcinomas should be treated with surgery. Superficial BCCs may be treated with cryotherapy and 5% imiquimod with fewer complications and better aesthetic results, but this results in higher tumor recurrence.