Nausea y vomito secundarios a la limpieza peritoneal en cesárea bajo anestesia subaracnoidea, eficacia de la asociación midazolam-fentanil. Ensayo clínico controlado
dc.contributor.advisor | Garcia Marquez, Mario Javier | |
dc.contributor.author | García Corzo, Carlos Miguel | |
dc.date.accessioned | 2024-03-03T16:17:31Z | |
dc.date.available | 2006 | |
dc.date.available | 2024-03-03T16:17:31Z | |
dc.date.created | 2006 | |
dc.date.issued | 2006 | |
dc.description.abstract | Con el objetivo de evaluar el riesgo de desarrollar nausea y vómito secundario a la limpieza peritoneal, en pacientes sometidas a cesárea bajo anestesia subaracnoidea utilizando una mezcla de fentanil más midazolam EV previo a dicha manipulación se diseño un ECC triplemente enmascarado y multicéntrico. Se aleatorizaron dos grupos y 385 pacientes y se utilizó en el grupo intervenido una mezcla que contenía 1 mgr de Midazolam + 50 mcrgrs de fentanil (volumen final de 2cc) y el grupo control una mezcla que contenía 2cc de solución salina normal; quienes aplicaban la droga estaban enmascarados respecto a su contenido. Las náuseas y el vómito se evaluaron de acuerdo a su presentación posterior a la manipulación del peritoneo (limpieza de cavidad). La técnica anestésica se estandarizó para los dos grupos utilizando Bupivacaina 0.5% 10 mgrs + 25 microgramos de fentanil vía subaracnoidea. En el grupo intervenido los riesgos absolutos (RA) de Náusea, vomito o ambos simultáneamente fueron menores (7.11 vs. 3.19), los riesgos relativos (RR) no fueron significativos (p=0.093 y 0.356). El nivel alcanzado entre T2-T4 presentó menor RA de nauseas o vomito comparado con T5-T7. Hubo mayor RR de sedación en el grupo intervenido (RR: 3.11 IC 95% 2.24-4.31 p=0.000) y un menor RA de utilizar coadyuvantes tipo midazolam y metoclopramida. Los efectos secundarios como hipotensión, prurito, dolor intraoperatorio (IOP), temblor, ansiedad no mostraron diferencias significativas entre los dos grupos. frecuente procedimiento anestésico realizado bajo anestesia regional subaracnoidea. | |
dc.description.abstractenglish | Visceral pain related to peritoneal traction may play a role in causing intraoperative emetic symptoms during spinal anesthesia for cesarean section. In a randomized, triple blind, multicentric, controlled trial we have evaluated the efficacy of intravenous midazolam and fentanyl as a prophylactic treatment of nausea and vomiting associated with the traction of peritoneum in patients who deliver by cesarean section under spinal anesthesia. 385 patients gave their consent to participate in the study. They were randomly assigned into one of two treatment groups: Fentanyl-Midazolam and normal saline. At least 3 min before the peritoneal traction, patients received an intravenous mixture of fentanyl (50 mcg) and midazolam (1 mg) or an equal volume of normal saline (2 cc). Anesthesiologists were blinded to treatment group. Each patient received a spinal injection of 10 mg of hyperbaric bupivacaine 0.5% with 25 mcg fentanyl. Although the Fentanyl-Midazolam group had a smaller absolute risk (AR) of nausea, vomiting or both comparing to the normal saline group (3.19 vs 7.11, 1.59 vs 3.04, and 1.6 vs 3.05 respectively); there were no significant differences in relative risks (p=0.093 y 0.356). With a T2-T4 sensitive level, the absolute risk of nausea and vomiting was smaller in comparison to T5-T7 level. There was greater risk of sedation in the intervention group (RR: 3.11 IC 95% 2.24-4.31 p=0.000), but there was less absolute risk of using midazolam or metocopramide as a co-adjuvant drug. There were no significant differences in the presence of hypotension, pruritus, intraoperative pain, anxiety and shivering between the two groups. Additional studies are required to help us to reduce these secondary effects, which we have not been able to remove of the majority of the patients who receive spinal anesthesia | |
dc.description.degreelevel | Especialización | |
dc.description.degreename | Especialista en Anestesiología y Reanimación | |
dc.format.mimetype | application/pdf | |
dc.identifier.instname | Universidad Industrial de Santander | |
dc.identifier.reponame | Universidad Industrial de Santander | |
dc.identifier.repourl | https://noesis.uis.edu.co | |
dc.identifier.uri | https://noesis.uis.edu.co/handle/20.500.14071/19409 | |
dc.language.iso | spa | |
dc.publisher | Universidad Industrial de Santander | |
dc.publisher.faculty | Facultad de Salud | |
dc.publisher.program | Especialización en Anestesiología y Reanimación | |
dc.publisher.school | Escuela de Medicina | |
dc.rights | http://creativecommons.org/licenses/by/4.0/ | |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | |
dc.rights.creativecommons | Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) | |
dc.rights.license | Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0 | |
dc.subject | Náuseas | |
dc.subject | Vómito | |
dc.subject | Anestesia | |
dc.subject | Subaracnoidea | |
dc.subject | Obstetricia | |
dc.subject | Cesárea | |
dc.subject | Ensayo Clínico | |
dc.subject | Fentanil | |
dc.subject | Midazolam | |
dc.subject.keyword | Nausea | |
dc.subject.keyword | Vomiting | |
dc.subject.keyword | Anesthesia | |
dc.subject.keyword | Spinal | |
dc.subject.keyword | Obstetrics | |
dc.subject.keyword | Cesarean | |
dc.subject.keyword | controlled trial | |
dc.subject.keyword | Fentanyl | |
dc.subject.keyword | Midazolam. | |
dc.title | Nausea y vomito secundarios a la limpieza peritoneal en cesárea bajo anestesia subaracnoidea, eficacia de la asociación midazolam-fentanil. Ensayo clínico controlado | |
dc.title.english | Nausea and secondary vomit to the cleanliness peritoneal in caesarean under anesthesia subaracnoidea. efficiency of the association midazolam - fentanil. clinical controlled test(essay) | |
dc.type.coar | http://purl.org/coar/version/c_b1a7d7d4d402bcce | |
dc.type.hasversion | http://purl.org/coar/resource_type/c_7a1f | |
dc.type.local | Tesis/Trabajo de grado - Monografía - Pregrado |