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Combinación de infusión en catéter perineural y en la herida en la amputación por encima de la rodilla: un estudio multicéntrico controlado y aleatori

REVISTA

Descripción: Se colocaron dos catéteres, uno en la vaina del nervio ciático y otro debajo de la fascia, dicha combinación parece disminuir la intensidad del dolor del muñón después de la amputación

TITULO FUENTE ORIGINAL:

Combination of perineural and wound infusion after above knee amputation: A randomized, controlled multicenter study

AUTORES:

Hanna von Plato, Marko Peltoniemi, Petteri Kauhanen, Eliisa Löyttyniemi, Katri Hamunen, Vesa Kontinen, FinAPain-1 study group

REVISTA ABREV.:

Acta Anaesthesiol Scand

AÑO:

2019

REFERENCIA:

63(10):1406-1412

DOI:

10.1111/aas.13440

RESUMEN ORIGINAL:

Background: Post-operative pain after an above-knee amputation is often severe, and in the elderly patients the adverse effects of post-operative opioids are evident. We hypothesized that continuous perineural local anesthetic infusion (CPI) combined to a wound infusion will reduce acute pain and opioid consumption compared to placebo after above knee amputation. Methods: Ninety-three... + Leer más

Background: Post-operative pain after an above-knee amputation is often severe, and in the elderly patients the adverse effects of post-operative opioids are evident. We hypothesized that continuous perineural local anesthetic infusion (CPI) combined to a wound infusion will reduce acute pain and opioid consumption compared to placebo after above knee amputation.

Methods: Ninety-three patients going through an above knee amputation were recruited for this randomized, controlled trial. Two catheters were placed, one to the sciatic nerve sheath and one under the fasciae during the amputation. After two 10 mL boluses of ropivacaine 0.75% a post-operative infusion of ropivacaine 0.2% or placebo (NaCl 0.9%) at 2 mL/h was administered for 72 hours to both catheters. The primary outcome was average stump pain during the first 5 days.

Results: The mean intensity of stump pain during the first five post-operative days was 1.4 (0.8) in the CPI group and 1.9 (0.9) in the placebo group on VRS, mean (SD), P = .006. The opioid consumption on first five post-operative days did not differ between the groups.

Conclusion: A combination of continuous perineural and wound local anesthetic infusion seems to diminish the intensity of stump pain after above knee amputation

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