Valoración del dolor postoperatorio inmediato aplicando técnica de no cierre del peritoneo parietal en gestantes intervenidas por cesárea. Hospital Gineco Obstétrico Enrique C. Sotomayor
No hay miniatura disponible
Fecha
2013
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La cesárea es una de las intervenciones quirúrgicas más frecuentes a nivel mundial. Numerosas generaciones de cirujanos ginecólogos obstetras han estandarizado su técnica, sin embargo existen muchas formas posibles de realizar una cesárea y las técnicas quirúrgicas utilizadas en la cesárea varían. El procedimiento quirúrgico en cesárea ha sido revisado en múltiples estudios, ya sea con particularidades como por ejemplo cerrar o no el peritoneo en su totalidad como es el caso de los estudios que comparan diferentes técnicas de cesárea con el único propósito de disminuir morbilidad y mortalidad. La incidencia de cesáreas se ha incrementado en los últimos años y la presencia de dolor postoperatorio constituye un reto para el médico buscando una amplia variedad de fármacos analgésicos con mínimos efectos secundarios. El presente estudio valoró el dolor postoperatorio inmediato aplicando técnica de no cierre del peritoneo parietal en gestantes intervenidas por cesárea. Mediante un estudio tipo descriptivo de diseño longitudinal, se analizó una muestra de 99 gestantes en el lapso de seis meses, las mismas que ingresaron al área toco quirúrgico del Hospital Enrique C. Sotomayor, las cuales tenían una edad media de 23 años, con un embarazo a término en promedio de 38 semanas y que en su mayoría tuvieron un diagnostico quirúrgico de distocia de presentación. De los casos valorados en éste análisis el 100 % de las pacientes experimentó dolor postoperatorio inmediato moderado, el 64.65 % de las gestantes no necesitó dosis extras de analgesia y un 35.35 % si lo requirió. El tiempo quirúrgico en que se realizó la cesárea sin cierre de peritoneo parietal fue en promedio 35 minutos en un rango de 21 - 40 minutos, demostrando ventajas al omitir este paso.
The cesarean section is one of the most widely used surgical interventions worldwide. Numerous generations of surgeons in gynecology and obstetrics have standardized their technique. There are, however, many possible ways of carrying out a cesarean section. This surgical procedure has been revised in multiple studies, including some particular processes, such as with or without a peritoneal closure in its totality as is the case of the studies that compare different techniques with the singular purpose of lowering morbidity and mortality. The incidence of cesarean sections has increased in recent years and the presence of post-surgical pain presents a challenge for the physician in seeking a wide range of analgesics with minimal secondary effects. The present study evaluated immediate post- surgical pain applying the non-closure of the parietal peritoneum in mothers who underwent a Cesarean Section. Following a descriptive longitudinal study model; a sample of ninety-nine women in gestation in the time lapse of six months, who were admitted to the surgical area of the Enrique C. Sotomayor Hospital. These women had a mean age of twenty three years and full term pregnancy of thirty eight months average. Most of them presented with a surgical diagnosis of ‘dystocia’ upon presentation. On the cases evaluated, 100% of the patients presented with moderate post-surgical pain, 64.65% did not require additional dosages of analgesics and 35.35 % required more medication. The surgery was completed in average in 35 minutes with a range of 21 to 40 minutes, demonstrating the advantages of omitting this step.
The cesarean section is one of the most widely used surgical interventions worldwide. Numerous generations of surgeons in gynecology and obstetrics have standardized their technique. There are, however, many possible ways of carrying out a cesarean section. This surgical procedure has been revised in multiple studies, including some particular processes, such as with or without a peritoneal closure in its totality as is the case of the studies that compare different techniques with the singular purpose of lowering morbidity and mortality. The incidence of cesarean sections has increased in recent years and the presence of post-surgical pain presents a challenge for the physician in seeking a wide range of analgesics with minimal secondary effects. The present study evaluated immediate post- surgical pain applying the non-closure of the parietal peritoneum in mothers who underwent a Cesarean Section. Following a descriptive longitudinal study model; a sample of ninety-nine women in gestation in the time lapse of six months, who were admitted to the surgical area of the Enrique C. Sotomayor Hospital. These women had a mean age of twenty three years and full term pregnancy of thirty eight months average. Most of them presented with a surgical diagnosis of ‘dystocia’ upon presentation. On the cases evaluated, 100% of the patients presented with moderate post-surgical pain, 64.65% did not require additional dosages of analgesics and 35.35 % required more medication. The surgery was completed in average in 35 minutes with a range of 21 to 40 minutes, demonstrating the advantages of omitting this step.
Descripción
PDF
Palabras clave
Cesárea, Dolor postoperatorio, Cierre peritoneal, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador