Manejo del dolor postoperatorio con morfina en anestesia espinal en cirugía gineco-obstétrica de la Fundación Pablo Jaramillo Crespo

Abstract

Objective: To evaluate the efficacy of the treatment in postoperative pain with the use of morphine in conductive anesthesia in patients with gynecological obstetric surgery. Pablo Jaramillo Crespo Foundation; September-December 2011, Cuenca 2015. Methods: It is an observational, analytical, prospective and quantitative study. They included, with the classification of the American Society of Anesthesiologists (ASA) I and II, to 231 patients between 15 and 65 years, who were hospitalized in the Pablo Jaramillo Crespo Foundation for gynecological-obstetric surgery, conducted from September to December 2011. Doses of morphine were administered: 2 mg for epidural and 0.2 mg for spinal anesthesia. The pain was assessed at 12 and 24 hours, with the visual analog scale of pain intensity (VAS). Results: The morphine used did not have preservatives. It was observed that spinal anesthesia shows a slight advantage to the epidural, with better tolerance to pain at 12 and 24 hours (p <0.05). There was no a relationship between the etiology of obstetric and gynecological surgeries with pain at 12 and 24 hours (p>0.05). In 25.78% of cases, the morphine analgesia for spinal administration was supplemented using ketorolac intravenously. A 49.2% of patients did not show side effects of these. The most observed were: pruritus (13.14%), urinary retention (11. 3%), nausea (9.8%) and vomiting (6.9%). Conclusion: The use of morphine dose: 2 mg for epidural and 0,2 mg for spinal anesthesia, provides a favorable recovery of pain in patients with gynecological and obstetric surgery. The side effects caused by their administration can be handled efficiently without altering the postoperative recovery