Tolerabilidad de tapentadol contra tramadol en analgesia posoperatoria en pacientes sometidos a anestesia general balanceada en el CHMH

Abstract

Resumen Introducción. Tramadol se utiliza para controlar el dolor postoperatorio moderado a severo; asociado a nausea y vómito en las 24 horas del postoperatorio. Una alternativa es Tapentadol. Estudios recientes indican una tasa de éxito similar a Tramadol, con menor incidencia de eventos adversos Objetivo. Evaluar y comparar el dolor postoperatorio en dos grupos de pacientes tratados con Tapentadol vía oral contra Tramadol endovenoso, así como evaluar y comparar la incidencia de eventos adversos. Metodología. Estudio clínico experimental, prospectivo, longitudinal y comparativo. Tomamos pacientes de cirugía maxilofacial bajo anestesia general. Designamos dos grupos: A para Tapentadol y B para Tramadol de forma aleatorizada. Premedicamos con dexametasona 8 mg y ondansetron 4 mg vía endovenosa. Grupo A, Tapentadol 50 mg vía oral 60 minutos previo a la inducción anestésica y al grupo B, Tramadol 1mg/kg posterior a la inducción anestésica. Medicamos ambos grupos con paracetamol 10mg/kg. Evaluamos el dolor postoperatorio con la escala de EVA al salir de quirófano, de la Unidad de Cuidados Postanestésicos (UCPA) y a las 24 horas, así como la náusea y vómito. El uso de otro analgésico, se evaluó a las 24 horas. Resultados. Incluimos 17 pacientes en el estudio, 7 para el grupo A y 10 para el grupo B, Comparamos entre grupos la medición del EVA post cirugía, post UCPA, así como nausea y vómito, no encontramos diferencias significativas entre los grupos. Conclusiones. La evidencia clínica del estudio orienta que Tapentadol es equipotente a tramadol, sin diferencias significativas en la presentación de efectos adversos. Palabras clave: Tolerabilidad, tapentadol, tramadol, nausea, vomito, dolor

Abstract Introduction. Tramadol is use for moderate to severe postoperative pain. It´s associated with nausea and vomiting, mainly within 24 hours of the postoperative period. An alternative is Tapentadol. Recent studies associated a success rate similar to Tramadol, with a lower incidence of adverse events. Objective. To evaluate and compare postoperative pain in two groups of patients treated with Tapentadol orally against intravenous Tramadol, as well as to evaluate and compare the incidence of adverse events. Methodology. Experimental, prospective, longitudinal and comparative clinical study, patients were taken, of maxillofacial surgery under general anesthesia. Two groups were designated: A for tapentadol and B for Tramadol in a randomized manner. We premedicated with dexamethasone 8 mg and ondansetron 4 mg intravenously. We administered: Group A, 50 mg of Tapentadol orally 60 minutes prior to anesthetic induction. Group B, Tramadol 1 mg/kg after anesthetic induction. Both groups were medicated with paracetamol 10 mg/kg after induction. Postoperative pain was assessed with the EVA scale when leaving the operating room, Post-Anesthesia Care Unit (PACU) and at 24 hours, as well as the presence of nausea and vomiting. The use of other analgesic was evaluated at 24 hours. Results. We included 17 patients in the study, 7 patients for group A and 10 for group B. When compared. measurements VAS post surgery, post anesthesia care unit were compared between groups, as well as nausea and vomiting, no significant differences were found. Conclusions. Clinical evidence from the study indicates that Tapentadol is equipotent to tramadol, with no significant differences in the presentation of adverse effects. Key words: Tolerability, tapentadol, tramadol, nausea, vomiting, pain