masterThesis
Comparación entre analgesia epidural continua vs bloqueo nervio periférico en niños llevados a cirugía múltiple de miembros inferiores
Fecha
2013Autor
Trillos Vera, Julio Efraín
Montes, Felix Ramon
Quintero Beltran, Oscar
Turriago, Camilo
Medina, Astrid
Institución
Resumen
Multiple reconstructive surgeries of lower limbs involve a difficult postoperative analgesia management; analgesic technique currently used is epidural analgesia , but the adverse effects associated with this do not make it an ideal technique for pain management . Peripheral nerve blocks have emerged as an alternative for pain management , but is not widely use. We intended to evaluate the decrease of adverse effectes with the use of peripheral nerve blocks vs epidural analgesia .
This initial pilot study was conducted to verify effectiveness of the techniques used and problems that may arise . Protocol was applied in 23 patients who underwent surgery of the lower limbs who were divided into 2 groups 11 received peripheral nerve blocks and 12 epidural analgesia . Patients were followed for 48 hours and evaluated for control of pain and opioid effects.
The block placement time was similar in both groups , the group of blocks presented fewer episodes of pain and fewer episodes of severe pain . Urinary retention is not present in any patient but in the epidural group had higher incidence of nausea and vomiting ( 60 % vs 45 % ) .
We found that peripheral nerve blocks are an appropriate choice for pain management in this type of surgery , and appears to reduce the incidence of adverse events associated with epidural analgesia .