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Espinoza Bernal, Flora Judith (2016)
Languages: Spanish; Castilian
Types: Master thesis
Subjects: BLOQUEO PLEXO BRAQUIAL, BUPIVACAINA, MORFINA, EFECTOS COLATERALES
Introducción: La cirugía de miembro superior es un reto para el anestesiólogo por que amerita el dominio de técnicas de anestesia regional y manejo de complicaciones y analgesia en las primeras 48 horas. Objetivo: Comparar la eficacia anestésica entre bupivacaína al 0.25% + morfina y bupivacaína al 0.25% en bloqueo del plexo braquial para cirugía de miembro superior en el H.V.C.M, Cuenca 2014. Metodología: se diseñó un estudio clínico aleatorio simple ciego, para valorar el efecto de la adición de bupivacaína más morfina vs bupivacaína en pacientes mayores de 18 años con bloqueo del plexo braquial. Los pacientes del Grupo I recibieron Bupivacaína 0.25% 75 mg y los pacientes del Grupo II Bupivacaína 0.25% 75 mg + morfina 50 ug/kg. Se monitorizó tiempo de latencia, bloqueo motor, bloqueo sensitivo, analgesia postoperatoria y efectos colaterales. Resultados: los grupos de estudio fueron comparables por la edad, sexo, tipo de intervención, peso, talla y tiempo quirúrgico. El tiempo de latencia es mayor en el grupo de la bupivacaína 11,16 minutos en relación al grupo bupivacaína + morfina 4,11 minutos, valor de p=0,000. De igual manera, la adición de bupivacaína + morfina provee más del doble de tiempo de analgesia 915,79 minutos en comparación con la administración única de bupivacaína 280,53 minutos, valor de p=0,000. Los efectos colaterales fueron mayores para la adición bupivacaína y morfina. Conclusiones: La adición de bupivacaína más morfina provee un menor tiempo de latencia y mayor tiempo de analgesia postoperatoria Introduction: Surgery of men in certain cases can be a challenge to the anesthesiologist that warrants of the domain of certain techniques of regional anesthesia and management of complications and analgesia in the first 24-48 hours. Objective : To compare the effectiveness between anesthetic bupivacaine 0.25% + morphine and 0.25 % bupivacaine alone in the blockade of the brachial plexus for surgery of the upper limb at the Hospital Vicente Corral Moscoso, Cuenca 2014. Methodology: design a randomized clinical study single-blind, to assess the effect of the addition of bupivacaine more morphine vs. bupivacaine alone in patients older than 18 years operated with supraclavicular brachial plexus block. The Group I patients received bupivacaine 0.25 % 75 mg in a total volume of 30 ml and the patients of the Group II were treated with 0.25 % bupivacaine 75 mg + morphine 50 ug/kg in a total volume of Results: the study groups were comparable in age, sex, type of intervention, weight, height and surgical time. A significant difference was found in the average latency of 7.05 minutes. The latency time is greater in the group of bupivacaine 11.16 minutes in relation to the group that received bupivacaine + morphine 4.11 minutes, p-value=0.000 . Similarly, the addition of bupivacaine + morphine provides more than double the time of 915.79 minutes analgesia when compared with the single administration of bupivacaine 280.53 minutes, p-value=0.000 . Side effects such as vomiting were higher for the addendum bupivacaine and morphine Especialista en Anestesiología Cuenca
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