masterThesis
Alternativas a la morfina intratecal para el manejo del dolor agudo post-cesárea en Latinoamérica : revisión sistemática de la literatura
Fecha
2018Autor
Cabrera Hernández, Juan
Rojas Rodriguez, Claudia Marcela
Institución
Resumen
Introduction: Caesarean section is a frequent and painful procedure. Although intrathecal morphine is the current gold-standard for pain management, its use is sometimes limited. The present study seeks to determine the alternatives to intrathecal morphine for acute post-cesarean pain management in Latin America in the last 10 years of publications.
Methodology: A systematic review of the literature was carried out. The Medline, Embase, Google Scholar and LILACS databases were reviewed. Studies frome the last 10 years where included.
Results: Five alternatives to intra-thecal morphine were found; these were: Dexamethasone, Ropivacaine and peridural fentanyl, peridural or intravenous tramadol, bupivacaine and peridural morphine, bupivacaine infiltration and paracetamol with intravenous tramadol or ketorolac. The safety profile of the alternatives was adequate with few adverse events reported.
Conclusion: 5 alternatives for intrathecal morphine in Latin America were found in this sistematic review of the literature. No meta-analysis was found to establish the superiority of any of these methods. The level of scientific production in the region is lagging behind. There is a need for double-blind randomized studies and meta-analyzes to clarify the superiority of some of these methods over others.