Eficacia analgésica del bloqueo de los nervios pectorales en cirugía de mama / No disponible
Cir. mayor ambul
; 16(2): 89-93, abr.-jun. 2011. ilus, tab
Article
em Es
| IBECS
| ID: ibc-92719
Biblioteca responsável:
ES1.1
Localização: BNCS
RESUMEN
Introducción: Los procedimientos de reconstrucción mamaria tienen una rápida recuperación postoperatoria producen un dolor de moderado a intenso requiriendo un abordaje multimodal para garantizar un buen control postoperatorio del mismo. Material y métodos: Estudio observacional prospectivo realizado en 20 mujeres con cáncer de mama programadas para cirugía con reconstrucción mamaria. Previo a la anestesia general, como parte del abordaje multimodal del dolor, se realizó un bloqueo de los nervios pectorales utilizando una sonda lineal de ultrasonidos. Se localizó el espacio entre los músculos pectorales mayor y menor para luego depositar un bolo de 0,4 ml/kg de levobupivacaína al 0,25%. Treinta minutos antes de finalizar la cirugía se administraron 50 mg de dexketoprofeno y 1 g de paracetamol intravenoso, pautado posteriormente cada 8 horas respectivamente. La analgesia de rescate fue 2 mg de cloruro mórfico. La evaluación postoperatoria del dolor fue realizada a los 30 minutos, 1, 2, 4, 8, 12, 24 y 48 horas, mediante la escala verbal numérica (de 0 = no dolor a 10= máximo dolor imaginable). A las 48 horas se realizó una encuesta del grado de satisfacción y de la técnica analgésica mediante un cuestionario directo. Las náuseas y vómitos se evalúan al ingreso en la unidad de recuperación postanestésica, a las 24 y 48 horas mediante escala numérica de 0 a 3.Resultados: De los 20 pacientes a los 30 minutos postcirugía,11 presentaron dolor leve o nulo (< 3), 6 dolor moderado (4-5) y solo 3 dolor severo (> 6). En las evaluaciones posteriores de dolor ningún paciente presentó dolor severo. La valoración de la técnica (..) (AU)
ABSTRACT
Introduction: Breast reconstructive surgery has a fast recovery, and the pain can be classified between moderate to severe during the postoperative period. This is why a multimodal approach is required. Material and methods: Prospective observational study in 20 women booked for reconstructive breast surgery. Prior to the operation we performed an ultrasound guided pecs block with a linear probe. This was part of the multimodal approach for pain control. The plane between the pectoralis major and minor was located and 0.4 ml/kg of 0.25% levobupivacaine was injected. Thirty minutes before the end of surgery dexketoprofeno (50 mg i.v.) and paracetamol(1 g i.v.) were administered. Rescue analgesia was prescribed as morphine 2 mg. Postoperative pain evaluation was recorded at 30 minutes, 1, 2, 4, 8, 12, 24 and 48 hours by visual analog scale (0 = no pain, 10 = worst imaginable pain). At 48 hours we performed a grade of satisfaction evaluation. Nausea and vomitus were evaluated at admission, 24 and 48 hours with a numeric scale from 0 to 3.Results: Out of the 20 patients 11 presented with pain less than 3, 6 with moderate pain (3 to 6) and only 3 with severe pain(more than 6). At a later stage no patient presented with severe pain. Grade of satisfaction was recorded as very good or excellent in 16 cases, good in 3 cases and only one regular. No patient said it was bad. In relation with nausea and vomitus 17 presented with none, 2 were moderate and 1 was severe. Conclusion: Ultrasound guided Pecs block can be useful inreconstructive breast surgery as part of the multimodal strategy for postoperative pain control. It can be consider as an alternative to paravertebral or thoracic epidurals (AU)
Buscar no Google
Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Neoplasias da Mama
/
Analgesia
/
Bloqueio Nervoso
Tipo de estudo:
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Humans
Idioma:
Es
Revista:
Cir. mayor ambul
Ano de publicação:
2011
Tipo de documento:
Article