Reducción del requerimiento de opiodes en cirugía de mama utilizando lidocaína en infusión intraoperatoria
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Date
2022-12-28
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Universidad Nacional de Trujillo
Abstract
El dolor post quirúrgico sigue siendo un problema y cuantificado inconsistentemente. El dolor después de un tratamiento oncológico puede afectar la calidad de vida del paciente y su familia. La lidocaína en infusión tanto intra como post operatoria surge como una estrategia para disminuir el consumo y abuso de opiodes, reducir los efectos secundarios y evitar la recuperación post operatoria prolongada. La lidocaína apoya el principio de analgesia multimodal, haciendo uso de una diversidad de medicamentos que pueden combinare para tener efectos sinérgicos y menor consumo de opiodes, brindando un tratamiento más eficaz del alivio del dolor. Objetivos: Demostrar si la lidocaína en infusión intraoperatoria reduce el requerimiento de opioides en cirugía de mama en el IREN NORTE, 2021. Metodología: Estudio analítico observacional prospectivo, en 84 pacientes con cáncer de mama que cumplan los criterios de selección, 42 pacientes serán expuestas a lidocaína 2% en infusión intraoperatoria a razón de 2mg/kg/h y 42 pacientes no serán expuestas a lidocaína. Ambos grupos serán sometidos a Anestesia Total Intravenosa /TIVA) y recibirán un esquema de analgesia habitual. Se evaluará el dolor post operatorio hasta completar las 24 horas desde su pase a recuperación mediante Escala Visual Análoga, cantidad y dosis de rescates.
Post-surgical pain continues to be a problem and is not consistently quantified. Pain after cancer treatment can affect the quality of life of the patient and their family. Lidocaine infusion both intra- and postoperatively emerges as a strategy to reduce opioid consumption and abuse, reduce side effects, and avoid prolonged postoperative recovery. Lidocaine supports the principle of multimodal analgesia, using a variety of medications that can be combined to have synergistic effects and reduce opioid consumption, providing a more effective pain relief treatment. Objectives: To demonstrate whether lidocaine in intraoperative infusion reduces the requirement for opioids in breast surgery in the IREN NORTE, 2021. Methodology: Prospective observational analytical study, in 84 patients with breast cancer who meet the selection criteria, 42 patients will be exposed to 2% lidocaine in intraoperative infusion at a rate of 2mg/kg/h and 42 patients will not be exposed to lidocaine. Both groups will undergo Total Intravenous Anesthesia (TIVA) and will receive a usual analgesia scheme. Postoperative pain will be evaluated until completing 24 hours from the time you go to recovery using a Visual Analog Scale, quantity and dose of rescues.
Post-surgical pain continues to be a problem and is not consistently quantified. Pain after cancer treatment can affect the quality of life of the patient and their family. Lidocaine infusion both intra- and postoperatively emerges as a strategy to reduce opioid consumption and abuse, reduce side effects, and avoid prolonged postoperative recovery. Lidocaine supports the principle of multimodal analgesia, using a variety of medications that can be combined to have synergistic effects and reduce opioid consumption, providing a more effective pain relief treatment. Objectives: To demonstrate whether lidocaine in intraoperative infusion reduces the requirement for opioids in breast surgery in the IREN NORTE, 2021. Methodology: Prospective observational analytical study, in 84 patients with breast cancer who meet the selection criteria, 42 patients will be exposed to 2% lidocaine in intraoperative infusion at a rate of 2mg/kg/h and 42 patients will not be exposed to lidocaine. Both groups will undergo Total Intravenous Anesthesia (TIVA) and will receive a usual analgesia scheme. Postoperative pain will be evaluated until completing 24 hours from the time you go to recovery using a Visual Analog Scale, quantity and dose of rescues.
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Keywords
Lidocaína, Tramadol, Cáncer de Mama