RESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Analgesia/instrumentação , Analgesia/métodos , Infusões Subcutâneas/instrumentação , Infusões Subcutâneas/métodos , Anestesia Local/instrumentação , Anestesia Local/métodos , Analgesia/tendências , Analgesia , Infusões Subcutâneas , Anestesia Local/tendências , Anestesia LocalRESUMO
Objetivos: Presentamos una revisión sistemática de los ensayos clínicos que tuvieron como objetivo valorar la eficacia de la administración de anestésico local con catéter en la incisión quirúrgica, en pacientes sometidos a cirugía abdominal. Método: Selección de los estudios siguiendo los criterios de Jadad. Las variables evaluadas en cada estudio fueron: tipo de intervención y de incisión, tipo, dosis y concentración del anestésico local, sitio de ubicación o localización del catéter, analgesia de rescate, consumo de opioides y la aparición de efectos adversos. Resultados: Se han incluido 15 ensayos con puntuación media de Jadad de 4,6 que incluyen 1.139 pacientes agrupados según la ubicación del catéter: subfascial (6 estudios), subcutánea (8 estudios) y en ambas (1 estudio), y 6 estudios adicionales que están en fase de realización registrados en ClinicalTrials.gov. Discusión: La analgesia incisional es una técnica segura, cuya eficacia se ha observado en cesáreas e histerectomías realizadas mediante incisiones de Pfannenstiel. Los resultados son contradictorios en otras técnicas quirúrgicas. Faltan estudios para conocer la localización óptima del catéter así como la concentración y volumen adecuado (AU)
Objectives: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. Methods: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. Results: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. Conclusions: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume (AU)
Assuntos
Humanos , Feminino , Anestesia Local/instrumentação , Anestesia Local/métodos , Analgésicos Opioides/efeitos adversos , /instrumentação , /métodos , Catéteres , Cesárea/métodos , Histerectomia/métodosRESUMO
OBJECTIVES: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. METHODS: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. RESULTS: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. CONCLUSIONS: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume.
Assuntos
Abdome/cirurgia , Analgesia , Anestésicos Locais/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Analgesia/métodos , Humanos , Infusões IntralesionaisRESUMO
Objetivos: Presentamos una revisión sistemática de los ensayos clínicos que tuvieron como objetivo valorar la eficacia de la administración de anestésico local con catéter en la incisión quirúrgica, en pacientes sometidos a cirugía abdominal. Método: Selección de los estudios siguiendo los criterios de Jadad. Las variables evaluadas en cada estudio fueron: tipo de intervención y de incisión, tipo, dosis y concentración del anestésico local, sitio de ubicación o localización del catéter, analgesia de rescate, consumo de opioides y la aparición de efectos adversos. Resultados: Se han incluido 15 ensayos con puntuación media de Jadad de 4,6 que incluyen 1.139 pacientes agrupados según la ubicación del catéter: subfascial (6 estudios), subcutánea (8 estudios) y en ambas (1 estudio), y 6 estudios adicionales que están en fase de realización registrados en ClinicalTrials.gov. Discusión: La analgesia incisional es una técnica segura, cuya eficacia se ha observado en cesáreas e histerectomías realizadas mediante incisiones de Pfannenstiel. Los resultados son contradictorios en otras técnicas quirúrgicas. Faltan estudios para conocer la localización óptima del catéter así como la concentración y volumen adecuado(AU)
Objectives: We present a systematic review of clinical trials to evaluate the efficacy of infusing local anesthetic through a catheter placed in the abdominal surgical wound. Methods: The Jadad (Oxford) scoring system was used to select trials. The variables considered in relation to each trial selected were as follows: type of intervention and incision; type, dose, and concentration of local anesthetic; site where the catheter was placed; rescue analgesia required; opioid use; and incidence of adverse events. Results: Fifteen clinical trials with a mean Jadad score of 4.6 were selected. The 1139 patients enrolled in the trials were grouped according to catheter placement: subfascial (6 trials), subcutaneous (8 trials), and both (1 trial). Six additional unpublished trials registered at ClinicalTrials.gov were also located. Conclusions: Surgical wound analgesia is a safe technique whose effectiveness has been observed in cesarean sections and hysterectomies performed with Pfannenstiel incisions. Outcomes for other types of surgery are inconsistent. There is a lack of studies of the optimal site for catheter placement as well as of adequate anesthetic concentration and volume(AU)
Assuntos
Humanos , Masculino , Feminino , Anestesia Local/métodos , Anestesia Local , Anestésicos Locais/administração & dosagem , Eficácia/métodos , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de Intervenções , /instrumentação , Analgésicos Opioides/efeitos adversos , Anestesia Local/tendências , Abdome/cirurgia , /instrumentação , /métodos , Cesárea/instrumentação , HisterectomiaRESUMO
No disponible