RESUMO
Succinylcholine is the gold standard neuromuscular blocker for rapid sequence induction; however, its use is associated with fasciculation and myalgia. We performed a systematic review and meta-analysis of randomized controlled clinical trials comparing gabapentinoids versus placebo for the prevention of fasciculations and succinylcholine-induced myalgias. Six randomized clinical studies were included with a total of 481 patients - 241 in the intervention group and 240 in the placebo group. Gabapentinoids reduced the incidence of succinylcholine-induced myalgia (RRâ¯=â¯0.69, 95% CI 0.56-0.84, Pâ¯<â¯.001), which remained statistically significant for pregabalin (RRâ¯=â¯0.71, 95% CI 0.54-0.93, Pâ¯=â¯.013) and gabapentin (RRâ¯=â¯0.61, 95% CI 0.45-0.82, Pâ¯=â¯.001) separately. There was no difference in fasciculations between the groups (RRâ¯=â¯0.92, 95% CI 0.82-1.03, Pâ¯=â¯.148). Preoperative use of gabapentinoids is associated with lower incidence of succinylcholine-induced myalgias within the first 24â¯h of surgery.
RESUMO
La succinilcolina es el bloqueador neuromuscular de referencia para la inducción de secuencia rápida. Sin embargo, su uso se asocia a fasciculaciones y mialgias. Se realizó una revisión sistemática y un metaanálisis. Se incluyeron ensayos clínicos controlados aleatorizados comparando gabapentinoides frente a placebo, para la prevención de fasciculaciones y mialgias inducidas por succinilcolina. Se incluyeron seis estudios clínicos aleatorizados. El número total de pacientes fue de 481, de los cuales 241 se incluyeron en el grupo de intervención y 240 en el grupo de placebo. Los gabapentinoides redujeron la incidencia de mialgia inducida por succinilcolina (RR=0,69; IC95%: 0,56-0,84; p<0,001), que siguió siendo estadísticamente significativa para pregabalina (RR=0,71; IC95%: 0,54-0,93; p=0,013) y gabapentina (RR=0,61; IC95%: 0,45-0,82; p=0,001) por separado. No hubo diferencia entre los grupos en cuanto a fasciculaciones (RR=0,92; IC95%: 0,82-1,03; p=0,148). El uso preoperatorio de gabapentinoides se asocia a una menor incidencia de mialgias inducidas por succinilcolina dentro de las primeras 24horas posteriores al procedimiento. (AU)
Succinylcholine is the gold standard neuromuscular blocker for rapid sequence induction, however, its use is associated with fasciculations and myalgias. A systematic review and meta-analysis including randomized controlled clinical trials was performed comparing gabapentinoids versus placebo for the prevention of fasciculations and succinylcholine-induced myalgias. Six randomized clinical studies were included. The total number of patients was 481, of which 241 were in the intervention group and 240 in the placebo group. Gabapentinoids reduced the incidence of succinylcholine-induced myalgia (RR=.69; 95%CI: .56-.84; P<.001), which remained statistically significant for pregabalin (RR=.71; 95%CI: .54-.93; P=.013) and gabapentin (RR=.61; 95%CI: .45-.82; P=.001) separately. There was no difference between the groups in fasciculations (RR=.92; 95%CI: .82-1.03; P=.148). Preoperative use of gabapentinoids is associated with lower incidence of succinylcholine-induced myalgias within the first 24hours after the procedure. (AU)
Assuntos
Humanos , Fasciculação , Mialgia , Pregabalina , Gabapentina , SuccinilcolinaRESUMO
Se encuestó un total de 109 mujeres mayores de 40 años, quienes definieron a la menopausia en un 44% como un proceso natural y en un 40% como el cese de la menstruación. El 74 % de las encuestadas precisó que la menopausia era de causa natural y un 55% que afectó su vida sexual; asimismo un 40% refirió dolor al tener relaciones sexuales, un 57% que el deseo sexual disminuyó y un 12 % aumentado. En lo referente a los cambios en el estado de ánimo manifestaron tristeza en un 37%. El 88% de las encuestadas refirió haber presentado por lo menos un síntoma. La distribución de los síntomas en orden de frecuencia de los que manifestaron tener al menos uno de ellos, son: Bochornos 25%, Tristeza 17%, Soledad 15%, Insomnio 13% , Irritabilidad 13%, Dolor al tener relaciones sexuales 9%, Temblor 7%, Intento de suicidio 1%. El 45% refiere haber generado un cambio en su forma de vida y el 70% de la población estudiada no había recibido ningún tipo de información; un 86% de las encuestadas desearían recibir información y un 48% con una frecuencia de por lo menos una vez al mes.
The aim of this research was to determine knowledge about menopause in patients that go to the clinical practice at the Hospital de Puente Piedra, located 35 Km north of Lima, and whose population is mainly of a marginal urban area. A clinical interview was performed in 109 women over 40 between March-August 2005 that went to medical consultations to the different areas of the Hospital, asking them about their knowledge on menopause. Forty four percent of them considered menopause as a natural process and 40% considered menopause as the cessation of menstrual cycles. Seventy four percent of interviewed established menopause as a natural cause and 55% that it affected their sexual life. Also, 40% referred having pain at the moment of sexual intercourse, 57% that their sexual desire diminished and 12% that it increased. Related to mood changes, 37% manifested being sad, 88% referred presenting at least one symptom. Distribution of symptoms according to their frequency (admitting having at least one of them); hot flashes (25%), sadness (17%), loneliness (15%), insomnia (13%), irritability (13%), pain at sexual intercourse (9%), tremors (7%), suicidal attempts (1%). Forty five percent refers changes in their lifestyle and 70% of the population studied had not received any type of information, 86% of interviewed would like to receive information and 48% would like to receive information with a frequency of at least once a month. The population studied accepts menopause as menstrual cycle cessation and as a natural process, recognizes symptoms with changes in their lifestyle and have no IEC about this matter.