Incidencia del uso de ketamina en pacientes pediátricos Unidad de Quemados Hospital Francisco de Ycaza Bustamante 2009-2010
Fecha
2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La Ketamina es una antigua droga usada como inductor anestésico, que debido
a sus efectos adversos alucinatorios se subutilizó en las últimas décadas, pero a
proposito del avance de las neurociencias y al conocimiento del dolor, renace
como un potente medicamento analgésico (antihiperalgésico). La
probabilidad de desarrollar dolor crónico y sufrimiento a lo largo de la vida
puede reducirse con una analgesia apropiada, agresiva y administrada en el
momento adecuado. La ketamina es un potente agente hipnótico y analgésico
produce un estado de inconciencia llamado “anestesia disociativa” caracterizado
por el mantenimiento de los reflejos (p.e.de la tos y corneal) y movimientos
coordinados pero no conscientes. El manejo anestésico es complejo debido a
que en el paciente quemado se presentan cambios importantes en la
farmacocinética y farmacodinámica de muchos de los medicamentos
empleados. El objetivo general de ésta revisión es evaluar el uso de la ketamina
en pacientes del área de quemados en su relación con reducción del dolor en los
cambios de vendajes y además se medirá el tiempo de recuperación de la
conciencia de los niños que usan ketamina por vía intravenosa en el Hospital
Francisco de Ycaza Bustamante en el periodo comprendido entre Enero de 2009
a Diciembre de 2010. La metodología empleada es de tipo descriptivo
correlacional con diseño no experimental longitudinal retrospectivo,
obteniendo como resultado una alta incidencia de pacientes quemados entre
uno a cuatro años (71%) en un 85% se eliminó la percepción del dolor durante
los primeros 5 minutos medidos por EVA mientras que el 100% de niños
recuperaron el estado de conciencia antes de los 30 minutos
Ketamine is an old drug used to induce anesthesia, which due to its adverse effects are under-utilized delusional in recent decades, but due to the advancement of neuroscience and knowledge of pain medication is reborn as a powerful analgesic (anti-hyperalgesic). The probability of developing chronic pain and suffering throughout life can be reduced by appropriate analgesia, aggressive and administered at the right time. Ketamine is a potent hypnotic and analgesic produces a state of unconsciousness called "dissociative anesthesia" characterized by the maintenance of reflexes (cough and corneal pede) and coordinated movements but not conscious. Anesthetic management is complex because in the burn patient are significant changes in pharmacokinetics and pharmacodynamics of many drugs used. The overall objective of this review is to evaluate the use of ketamine in patients burned area in relation to pain reduction in dressing changes and also measured the recovery time of the awareness of children using ketamine intravenous Hospital Francisco Ycaza Bustamante in the period from January 2009 to December 2010. The methodology used is descriptive-correlational non-experimental longitudinal retrospective resulting in a high incidence of burn patients betwin one to four years (71%) in 85% removed the perception of pain during the first 5 minutes as measured by EVA while 100% of children regained consciousness 30 minutes before
Ketamine is an old drug used to induce anesthesia, which due to its adverse effects are under-utilized delusional in recent decades, but due to the advancement of neuroscience and knowledge of pain medication is reborn as a powerful analgesic (anti-hyperalgesic). The probability of developing chronic pain and suffering throughout life can be reduced by appropriate analgesia, aggressive and administered at the right time. Ketamine is a potent hypnotic and analgesic produces a state of unconsciousness called "dissociative anesthesia" characterized by the maintenance of reflexes (cough and corneal pede) and coordinated movements but not conscious. Anesthetic management is complex because in the burn patient are significant changes in pharmacokinetics and pharmacodynamics of many drugs used. The overall objective of this review is to evaluate the use of ketamine in patients burned area in relation to pain reduction in dressing changes and also measured the recovery time of the awareness of children using ketamine intravenous Hospital Francisco Ycaza Bustamante in the period from January 2009 to December 2010. The methodology used is descriptive-correlational non-experimental longitudinal retrospective resulting in a high incidence of burn patients betwin one to four years (71%) in 85% removed the perception of pain during the first 5 minutes as measured by EVA while 100% of children regained consciousness 30 minutes before
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Pediatría, Ketamina, Anestesia intravenosa, Quemaduras, Estudios retrospectivos, Epidemiología descriptiva, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador