Analgesia Epidural Postoperatoria: ¿cuál es su papel en la práctica anestésica actual?

Pérez, Neus Esteve; Fernandez, Cristianne

doi:10.20986/resed.2018.3654/2018

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…La técnica utilizada para control del dolor intra y posoperatorio es la analgesia peridural torácica, dada su superioridad en comparación con la analgesia intravenosa basada en opioides, principalmente en pacientes con riesgo de complicaciones cardiacas, respiratorias o íleo prolongado [9]. Ha demostrado reducir la respuesta simpática al estímulo quirúrgico y optimizar la función endócrina e inmunológica, siendo particularmente beneficiosa en pacientes con patología previa cardiovascular y respiratoria [10]. Si bien es el gold standard para el manejo del dolor en la toracotomía, en la cirugía por toracoscopía también se plantea igual de eficaz el bloqueo paravertebral con colocación de catéter para administración continua de anestésicos locales, presentando un perfil de seguridad mayor que la colocación de catéter peridural torácico (que presenta riesgo de complicaciones como hematoma peridural, absceso peridural, malposición del catéter, etc.)…”

Section: Discussionunclassified

Esofagectomía minimamente invasiva

Saxlund¹,

Gastelú²

2021

Rev. chil. anest.

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Introduction: Minimally invasive esophagectomy aims to reduce complications compared to open esophagectomy. In this report of the first patient undergoing this procedure at Hospital Pasteur, we highlight the importance of multidisciplinary management, and the main anesthesiological objectives. Objective: To present the case report highlighting the anesthetic management, together with the bibliographic review carried out in order to update the anesthetic action protocols, with the main objective of reducing the appearance of perioperative complications. Material and Method: Bibliographic search in PubMed bibliographic databases. Initially, 67 articles were obtained, selecting 20 considered relevant by the authors. Clinical case: It was a 46-year-old patient coordinated for esophagectomy for squamous neoplasm. Rapid sequence induction, selective endobronchial intubation and anesthetic maintenance with Isoflurane and epidural analgesia were performed. The hydroelectric replacement was restrictive. The surgical technique was performed in 3 stages: thoracic time by thoracoscopy; a second laparoscopic abdominal stage and a third stage for left cervicotomy. Extubation was carried out in the operating room with transfer to the ICU where she remained for 6 days to manage analgesia and due to the presence of a mild infectious complication, with good subsequent evolution. Conclusion:The use of perioperative multidisciplinary management protocols has fundamental importance as a strategy aimed at reducing morbidity and mortality. Advances in surgical technique added to anesthetic management constitute strategies that aim to reduce perioperative complications.

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Section: Discussionunclassified

Esofagectomía minimamente invasiva

Saxlund¹,

Gastelú²

2021

Rev. chil. anest.

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“…Actualmente la analgesia epidural solo se considera como técnica "gold estándar" en analgesia obstétrica (22,23). Una lista de factores a lo largo de los últimos años ha contribuido a limitar la indicación de la analgesia epidural a la cirugía abdominal mayor y torácica con abordaje abierto (24)(25)(26).…”

Section: Discussionunclassified