The objective of the study was to evaluate the effects of cryoanalgesia in patients undergoing posterolateral thoracotomy. A double-blind randomized and prospective study was performed in 100 patients undergoing thoracotomy. They were randomized into two groups: Group A, 55 patients, who had undergone an intercostal cryoanalgesia and group B, control, 45 patients treated only with pharmacological analgesia ad libitum. In both groups we assessed pain in the first 7 postsurgical days, the amount of analgesia required, electromyography of the intercostal muscles involved and recording of maximal static respiratory pressures. Postsurgical pain was significantly lower (p < 0.001) in group A. No patient in group A needed major analgesia and the amount of aminopyrines required was significantly lower (p < 0.001) than those used in group B. Maximal static inspiratory pressure (PImax) showed no significant changes and no significant differences were found between the two groups. Maximal static expiratory pressure (PEmax) significantly decreased (p < 0.001) in the 1st and 2nd week and it was not related to the type of analgesia used. We advocate the use of cryoanalgesia since it significantly reduces pain as well as the doses of analgesia.
Introducción: La mortalidad por las enfermedades cárdiovasculares ha constituido laprincipal causa de muerte, siendo importante averiguar la incidencia de lamorbimortalidad intrahospitalaria causada por estas enfermedades.Objetivos: El objetivo fundamental del presente trabajo es determinar la epidemiologíadel infarto agudo de miocardio (IAM) en el hospital San Marcos de Chinchiná.Materiales y métodos: Se realizó un estudio descriptivo y retrospectivo de 142 historiasclínicas del servicio de estadística del Hospital San Marcos de Chinchiná; lospacientes que se estudiaron presentaron infarto agudo de miocardio diagnosticadossegún criterios clínicos, enzimáticos y electrocardiográficos.Resultados: Se encontró una mortalidad del 3 %, y remisión del 43%; el IAM seobservó principalmente en pacientes del sexo masculino (53%), con una edad superiora 60 años. Dentro de los factores de riesgo controlables resulto que la hipertensiónarterial se asocia con mayor frecuencia al infarto agudo de miocardio, aunque la mayoríade los pacientes presentaron asociación simultanea de tres o más factores controlables;sin embargo la mayor proporción no presentó ninguna complicaciónintrahospitalaria post- infarto.Conclusiones: La aplicación de un tratamiento precoz ha demostrado influir independientementede manera favorable sobre la mortalidad hospitalaria.
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