RESUMEN Antecedentes y Objetivos: La analgesia del herido ha jugado un papel trascendental en la medicina militar. En la actualidad, continúa siendo un reto médico, táctico y logístico dentro del tratamiento integral de la baja en combate. El objetivo de este estudio es valorar la homogeneidad de los fármacos analgésicos administrados, del momento de inicio del tratamiento, del número y tipos de vías de acceso para administración de analgesia, así como del tipo de anestesia realizada en las bajas por arma de fuego o por artefacto explosivo atendidas en el ROLE 2E español de Herat (Afganistán) entre 2005 y 2008, siguiendo un índice de gravedad anatómico (NISS) de las lesiones. Material y métodos: Se realiza un estudio observacional, retrospectivo, obteniendo una muestra de 256 pacientes. Resultados: Los fármacos analgésicos más empleados fueron los AINEs (73%), seguidos de los mórficos mayores (44%), coadyuvantes (29%), mórficos menores (21%) y ketamina (12%). La analgesia se realizó a nivel prehospitalario en un 61% y a nivel intrahospitalario en un 31% de los casos. La vía de administración más frecuente fue la intravenosa (79%). En el 75% sólo se consiguió un acceso para medicación analgésica. El procedimiento anestésico más empleado fue la anestesia general (32%). Conclusiones: El tratamiento analgésico prestado a las bajas en combate de la muestra es homogéneo en cuanto a los fármacos empleados, el tipo y número de vías de administración conseguidas. Sin embargo es heterogéneo en cuanto al tipo de AINE elegido y al inicio en la administración de los fármacos analgésicos.
Background: Unilateral below knee amputation is a permanent surgical procedure that can influence the quality of life (QOL) of the person with amputation. The aim of this study was to assess the effects of ankle turner unit on the quality of life of unilateral below knee amputees. Methods: In a cross-sectional study, a total of twenty unilateral below-knee amputee patients were selected by simple random sampling. Quality of life of subjects was assessed with Trinity Amputation and Prosthesis Experience Scales (TAPES) questionnaire baseline and after 30 minute of using the unit. The participants were evaluated by five major criteria including: total TAPES score, conformity of movement restrictions, level of athletic activities, level of daily routine activities, and social activities, which were part of the TAPES survey. Results: In this study, 20 below-knee amputee male patients with average age of 47.7 years participated. Total index of TAPES with P = 0.01, matching of athletic restrictions with P = 0.04, athletic activity level with P = 0.006, and social activity level with P = 0.04 showed a significant difference compared to before using the unit. The difference in the level of daily routine activities, despite 5.15% increase in respect to before using the unit, was not significant (P = 0.2). Conclusions: The results implied that this unit can effectively improve the quality of life in amputees. In a detailed review of the study, it was proven that his unit resulted in an increase of the conformity with restrictions, and reduction of restrictions in athletic and social activities while it did not provide a positive effect on functional restrictions.
López Soberón E. Lecciones desde el campo de batalla: empleo de fentanilo transmucoso oral en personal militar, a propósito de un caso. Rev Soc Esp Dolor 2015; 22(2):
ABSTRACTThe improvements that have been progressively introduced in the treatment of pain in the battlefield have included increased training, research, availability of drugs and the most current techniques. One of analgesic that has been used first time in Iraq and Afghanistan conflicts has been oral transmucosal fentanyl (FTMO) generating an experience not only applicable in combat, but also in the civil and hospital environment. We describe a report of a soldier, who suffers an accident at work with chest and pelvic trauma requiring FTMO administration to achieve adequate pain control.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.