Sulfato de magnesio como coadyuvante de la analgesia multimodal para reducción del dolor postoperatorio
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2024
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: La eficacia y seguridad del sulfato de magnesio como coadyuvante de la analgesia postoperatoria (PO) ha presentado resultados disyuntos en distintos trabajos. El sulfato de magnesio permite optimizar la medicación analgésica, dando un mejor desarrollo postoperatorio del paciente. Objetivo: Evaluar la eficacia y seguridad del sulfato de magnesio como coadyuvante de la analgesia multimodal, en la reducción del dolor PO en anestesia general. Metodología: Estudio observacional, analítico correlacional, longitudinal prospectivo. Se estableció dos grupos de estudio:
grupo con sulfato de magnesio (GS) y control (GC). La eficacia se definió en términos de un mayor control del dolor, y menor consumo de opioide (fentanilo), mientras que la seguridad se definió en términos de menor alteración en las constantes vitales y menores eventos adversos. Estos desenlaces fueron medidos entre las 0-2,4 y 6 horas PO. Resultados: Se seleccionó 189 pacientes, edad promedio 41.8 años, 61.4% mujeres. En el GS y GC hubo 89 y 100 pacientes respectivamente. Durante las primeras dos horas se observó en el GS 88/89 sin dolor vs 91/100 en el GC (p=.0202). Se empleó rescate de fentanilo en 3/89 en el GS vs 9/100 en el GC (p=.1987). En el GC hubo más casos con picos hipertensivos (GS 9/89 vs GC 26/100;
p=.0088) y taquicardia (GS 7/89 vs GC 20/100; p=.0299). Se documentó hipotensión en 12/189 casos, todos del GS. Conclusión: en la muestra estudiada se observó que el sulfato de magnesio como adyuvante en la analgesia es significativamente más efectivo en términos de control del dolor.
Background: The efficacy and safety of magnesium sulfate as an adjunct to postoperative analgesia (PO) has presented mixed results in different works. Magnesium sulfate makes it possible to optimize analgesic medication, leading to a better postoperative development of patients. Aim: asess the efficacy and safety of magnesium sulfate as an adjunct to multimodal analgesia, in reducing PO pain in general anesthesia. Methods: Observational, analytical, correlational, prospective longitudinal study. Two study groups were established: group with magnesium sulfate (GS) and control group (GC). Efficacy was defined in terms of greater pain control and less opioid (fentanyl) consumption, while safety was defined in terms of less vital signs alterations and fewer adverse events, respectively. These outcomes were measured between 0-2, 2-4, and 4-6 hours PO. Results: 189 patients were selected, average age 41.8 years, 61.4% women. In the GS and GC there were 89 and 100 patients respectively. During the first two hours it was observed in the GS 88/89 without vs 91/100 in the CG (p=.0202). Fentanyl rescue was used in 3/89 in the GS vs 9/100 in the CG (p=.1987). In the CG there were more cases with hypertensive peaks (GS 9/89 vs GC 26/100; p=.0088) and tachycardia (GS 7/89 vs GC 20/100; p=.0299). Hypotension was documented in 12/189 cases, all from the GS. Conclusion: in the sample studied, it was observed that the use of magnesium sulfate as an adjuvant in analgesia was significantly more effective in terms of pain control.
Background: The efficacy and safety of magnesium sulfate as an adjunct to postoperative analgesia (PO) has presented mixed results in different works. Magnesium sulfate makes it possible to optimize analgesic medication, leading to a better postoperative development of patients. Aim: asess the efficacy and safety of magnesium sulfate as an adjunct to multimodal analgesia, in reducing PO pain in general anesthesia. Methods: Observational, analytical, correlational, prospective longitudinal study. Two study groups were established: group with magnesium sulfate (GS) and control group (GC). Efficacy was defined in terms of greater pain control and less opioid (fentanyl) consumption, while safety was defined in terms of less vital signs alterations and fewer adverse events, respectively. These outcomes were measured between 0-2, 2-4, and 4-6 hours PO. Results: 189 patients were selected, average age 41.8 years, 61.4% women. In the GS and GC there were 89 and 100 patients respectively. During the first two hours it was observed in the GS 88/89 without vs 91/100 in the CG (p=.0202). Fentanyl rescue was used in 3/89 in the GS vs 9/100 in the CG (p=.1987). In the CG there were more cases with hypertensive peaks (GS 9/89 vs GC 26/100; p=.0088) and tachycardia (GS 7/89 vs GC 20/100; p=.0299). Hypotension was documented in 12/189 cases, all from the GS. Conclusion: in the sample studied, it was observed that the use of magnesium sulfate as an adjuvant in analgesia was significantly more effective in terms of pain control.
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SULFATO DE MAGNESIO, DOLOR POSTOPERATORIO, PROCEDIMIENTOS QUIRURGICOS, HOSPITAL LUIS VERNAZA, CANTON GUAYAQUIL, ECUADOR