Tesis Especializaciones (Ciencias Médicas)

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Browsing Tesis Especializaciones (Ciencias Médicas) by Subject "Analgesicos"

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    Morfina + ketorolaco vs. morfina, para el control del dolor agudo postoperatorio y disminución de los efectos secundarios del opioide, Hospital José Carrasco Arteaga. Cuenca. 2011
    (2013) Bravo Briones, Ramón Eduardo; Buenaño Barrionuevo, Eduardo Efrén; Orellana Cabrera, Iván Eladio
    Objective. Compare additional morphine requirements association with morphine + ketorolac vs morphine infusion, for the postoperative pain control during major surgery and side effects of morphine .. Methodology. With a randomized controlled trial design included two groups of 80 patients each to receive: Morf + K group: 10 mg of morphine + 30 mg of ketorolac and Morf group: 10 mg of morphine. We measured the requirements of supplemental doses of morphine and the incidence of nausea and vomiting in both groups. Results. The groups were comparable in demographic variables. In the postoperative period pain was significantly lower in group Morf + K (P <0.001). Most patients required Morf group 1 and 2 additional dose of opioid. In group Morf + K 40% did not require supplemental doses of opioid. The average dose of morphine was also lower supplementary. The differences were significant (P <0.001). 40% of patients in the ketorolac group had nausea requiring treatment with ondansetron. In group Morf all patients had nausea and fifty percent of them nausea with vomiting. Ondansetron antiemetic treatment was administered to 90% of the group. In group Morf+ K40% had nausea requiring treatment. Discussion. The association of NSAIDs to opioids is a useful scheme for effective control of postoperative pain and reduces the incidence of postoperative nausea and vomiting as side effects of morphine.
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    Ventajas trans y post operatoria inmediata del no cierre del peritoneo en pacientes con cesárea en el Hospital José Carrasco Arteaga del IESS - Cuenca, 2010
    (2011) Cárdenas Mateus, Julio César; Molina Novillo, Javier Alonso; Mejía Chicaiza, Jorge Victoriano
    Objective. To determine the intraoperative and postoperative immediate benefits of non-closure of peritoneum versus closure of peritoneum at caesarean section patients. Methodology. With a randomized controlled trial design included two groups of 80 pregnant women each to be performed cesarean section: group 1 (G1) is not sutured parietal or visceral peritoneum and group 2 (G2) closure of the two peritoneum. Surgical time was measured in minutes, pain intensity, the requirements for supplementary doses of analgesics and the number of them and finally the restoration of bowel function postoperatively. Results. The groups were comparable in demographic variables. The average age was 28.3 ± 4.9 years in group 1 (Gl) and 30.5 ± 5.9 years in group 2 (G2) (p = 0.016 NS). In group 1, 43.8% were primiparous and 31.3% in group 2 (p = 0.8 NS). Statistically significant differences were found between the two groups: Group 1 (G1) showed reduction of surgical time (G1: 43.5 ± 6.9 minutes vs. Gl: 55.9 ± 5.27 minutes, p <0.001), decreased intensity of pain in Group I, only 13 patients (16.3%) experienced severe pain compared with 37 patients (46.3%) in group 2 who showed that magnitude of pain, p <0.001), therefore requiring less doses of analgesics used for pain control in G2 48.8% (39 patients) required 44 additional doses of analgesics and in group 1 in 32.8% (18 patients) had to be supplemented with analgesics p value <0.0001. There were no differences with respect to average hours of restoration of intestinal function by auscultation of bowel sounds the same as were between 12 and 24 hours postoperatively. It is suggested further study to track patients and identify long-term complications and their impact on morbidity and obstetric future. Discussion. The current trend in caesarean section does not close favors parietal and visceral peritoneum in relation to the reduction of surgical time, decreased intraoperative bleeding and postoperative pain