REVISTA

Adyuvantes de bloqueo nervioso anestésico local para la prolongación de la analgesia: una revisión cualitativa sistemática

Descripción: Adyuvantes de bloqueo nervioso periferico anestésico local para la prolongación de la analgesia. Los estudios de buprenorfina perineural, clonidina, dexametasona, dexmedetomidina y magnesio demostraron de manera más consistente la prolongación de los bloqueos nerviosos periféricos

TITULO FUENTE ORIGINAL:

Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review

AUTORES:

Kirksey MA, Haskins SC, Cheng J, Liu SS

REVISTA ABREV.:

Plos one

AÑO:

2015

REFERENCIA:

10(9):e0137312

DOI:

10.1371/journal.pone.0137312

RESUMEN ORIGINAL:

BACKGROUND:
The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased significantly in recent years. Adjuvants are frequently added to local anesthetics to prolong analgesia following peripheral nerve blockade. Numerous randomized controlled trials and meta-analyses have examined the pros and cons of the use of various individual...
+ Leer más

BACKGROUND:
The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased significantly in recent years. Adjuvants are frequently added to local anesthetics to prolong analgesia following peripheral nerve blockade. Numerous randomized controlled trials and meta-analyses have examined the pros and cons of the use of various individual adjuvants.

OBJECTIVES:
To systematically review adjuvant-related randomized controlled trials and meta-analyses and provide clinical recommendations for the use of adjuvants in peripheral nerve blocks.

METHODS:
Randomized controlled trials and meta-analyses that were published between 1990 and 2014 were included in the initial bibliographic search, which was conducted using Medline/PubMed, Cochrane Central Register of Controlled Trials, and EMBASE. Only studies that were published in English and listed block analgesic duration as an outcome were included. Trials that had already been published in the identified meta-analyses and included adjuvants not in widespread use and published without an Investigational New Drug application or equivalent status were excluded.

RESULTS:
Sixty one novel clinical trials and meta-analyses were identified and included in this review. The clinical trials reported analgesic duration data for the following adjuvants: buprenorphine (6), morphine (6), fentanyl (10), epinephrine (3), clonidine (7), dexmedetomidine (7), dexamethasone (7), tramadol (8), and magnesium (4). Studies of perineural buprenorphine, clonidine, dexamethasone, dexmedetomidine, and magnesium most consistently demonstrated prolongation of peripheral nerve blocks.

CONCLUSIONS:
Buprenorphine, clonidine, dexamethasone, magnesium, and dexmedetomidine are promising agents for use in prolongation of local anesthetic peripheral nerve blocks, and further studies of safety and efficacy are merited. However, caution is recommended with use of any perineural adjuvant, as none have Food and Drug Administration approval, and concerns for side effects and potential toxicity persist

- Leer menos

ENLACES DE INTERÉS

Enlace al pdf de acceso libre: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC[...]