{"id":32905,"date":"2018-03-09T09:29:45","date_gmt":"2018-03-09T09:29:45","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/dolor-postoperatorio-estudio-comparativo-entre-cuatro-protocolos-analgesicos-administrados-por-via-epidural-lumbar-y-su-influencia-sobre-la-respuesta-al-estres\/"},"modified":"2018-03-09T09:29:45","modified_gmt":"2018-03-09T09:29:45","slug":"dolor-postoperatorio-estudio-comparativo-entre-cuatro-protocolos-analgesicos-administrados-por-via-epidural-lumbar-y-su-influencia-sobre-la-respuesta-al-estres","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/dolor-postoperatorio-estudio-comparativo-entre-cuatro-protocolos-analgesicos-administrados-por-via-epidural-lumbar-y-su-influencia-sobre-la-respuesta-al-estres\/","title":{"rendered":"Dolor postoperatorio. estudio comparativo entre cuatro protocolos analgesicos administrados por via epidural lumbar y su influencia sobre la respuesta al estres."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Miguel Angel Ortells Polo <\/strong><\/h2>\n<p>El dolor agudo postoperatorio contin\u00faa siendo hoy en d\u00eda un problema sin resolver, situ\u00e1ndose su preValencia por encima del 50%. De todas las t\u00e9cnicas disponibles para el control del dolor postoperatorio, la analgesia epidural con cat\u00e9ter es el m\u00e9todo m\u00e1s eficaz para el alivio del mismo.  objetivos: comparar la eficacia analg\u00e9sica de 4 protocolos analg\u00e9sicos administrados a trav\u00e9s de un cat\u00e9ter epidural lumbar, basados en un anest\u00e9sico local, dos opi\u00e1ceos y un glucocorticoide, tras cirug\u00eda infradiagragm\u00e1tica electiva, mediante el uso de diferentes escalas dolorim\u00e9tricas (vas y e. De andersen).  comparar la incidencia de efectos colaterales atribuibles a la analgesia, as\u00ed como, la aparici\u00f3n de complicaciones graves postoperatorias. Tambi\u00e9n se valor\u00f3 la modulaci\u00f3n de la respuesta al estr\u00e9s ocasionado por dichos protocolos.  pacientes y m\u00e9todos: a 60 pacientes se les administr\u00f3 en el periodo postoperatorio uno de los 4 protocolos en estudio: a: 10 ml de bupivacaina al 0,25% + tramadol 1 mg\/kg de peso c\/24 h.; B: 10 ml de bupivacaina al 0,25% + morfina 5 mg c\/24 h.; C: morfina 1 mg + metil-prednisolona 80 mg, en bolo, morfina 5 mg + m- prednisolona 60 mg en 30 ml de s. Salino en perfusi\u00f3n a un ritmo de 0,5 ml \/ h. Durante 48 h.; D: tramadol 25 mg + 80 mg de m-prednisolona en bolo, tramadol 100 mg + m-prednisolona 60 mg en 30 ml de s. Salino en perfusi\u00f3n 0,5 ml \/ h. Durante 48 h.  se extrajeron muestras sangu\u00edneas basal, peroperatoria, y a las 6,12,24, y 48 horas, para determinar los valores de cortisol, acth, catecolaminas y betaendorfina.  conclusiones: la analgesia epidural contribuy\u00f3 a minimizar la respuesta hip\u00f3fiso-suprarrenal debida a la agresi\u00f3n quir\u00fargica, los 4 protocolos se muestran eficaces en el control de la respuesta al estr\u00e9s. La adici\u00f3n de m-prednisolona potencia la acci\u00f3n analg\u00e9sica de los opi\u00e1ceos, siendo segura su administraci\u00f3n en las plantas de hospitalizaci\u00f3n debido a l<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Dolor postoperatorio. estudio comparativo entre cuatro protocolos analgesicos administrados por via epidural lumbar y su influencia sobre la respuesta al estres.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Dolor postoperatorio. estudio comparativo entre cuatro protocolos analgesicos administrados por via epidural lumbar y su influencia sobre la respuesta al estres. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Miguel Angel Ortells Polo <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 C\u00e1diz<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 23\/01\/1997<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Mar\u00eda Sol Carrasco Jim\u00e9nez<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: felipe Garrido Garc\u00eda <\/li>\n<li>Miguel angel Nalda felipe (vocal)<\/li>\n<li>federico Rodriguez-rubio vidal (vocal)<\/li>\n<li>m. Jos\u00e9 Iribarren fernandez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Miguel Angel Ortells Polo El dolor agudo postoperatorio contin\u00faa siendo hoy en d\u00eda un problema sin resolver, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[1569,1506,9,141,387],"tags":[1575,1546,90218,1571,1093,90219],"class_list":["post-32905","post","type-post","status-publish","format-standard","hentry","category-anestesiologia-quirurgica","category-cadiz","category-ciencias-medicas","category-cirugia","category-cirugia-abdominal","tag-federico-rodriguez-rubio-vidal","tag-felipe-garrido-garcia","tag-m-jose-iribarren-fernandez","tag-maria-sol-carrasco-jimenez","tag-miguel-angel-nalda-felipe","tag-miguel-angel-ortells-polo"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/32905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=32905"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/32905\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=32905"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=32905"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=32905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}