Pharmacotherapy for the prevention of chronic pain after surgery in adults [documento electrónico] / Luis Enrique Chaparro Gómez,  . - 2013.
Obra : Cochrane Database of Systematic Reviews

Idioma : Francés (fre)

Resumen :	Background: Chronic pain can often occur after surgery, substantially impairing patients’ health and quality of life. It is caused by complex mechanisms that are not yet well understood. The predictable nature of most surgical procedures has allowed for the conduct of randomized controlled trials of pharmacological interventions aimed at preventing chronic postsurgical pain. Objectives: The primary objective was to evaluate the efficacy of systemic drugs for the prevention of chronic pain after surgery by examining the proportion of patients reporting pain three months or more after surgery. The secondary objective was to evaluate the safety of drugs administered for the prevention of chronic pain after surgery. Search methods: We identified randomized controlled trials (RCTs) of various systemically administered drugs for the prevention of chronic pain after surgery from CENTRAL, MEDLINE, EMBASE and handsearches of other reviews and trial registries. The most recent search was performed on 17 July 2013. Selection criteria: Included studies were double‐blind, placebo‐controlled, randomized trials involving adults and evaluating one or more drugs administered systemically before, during or after surgery, or both, which measured pain three months or more after surgery. Data collection and analysis: Data collected from each study included the study drug name, dose, route, timing and duration of dosing; surgical procedure; proportion of patients reporting any pain three months or more after surgery, reporting at least 4/10 or moderate to severe pain three months or more after surgery; and proportion of participants dropping out of the study due to treatment‐emergent adverse effects. Main results: We identified 40 RCTs of various pharmacological interventions including intravenous ketamine (14 RCTs), oral gabapentin (10 RCTs), oral pregabalin (5 RCTs), non‐steroidal anti‐inflammatories (3 RCTs), intravenous steroids (3 RCTs), oral N‐methyl‐D‐aspartate (NMDA) blockers (3 RCTs), oral mexiletine (2 RCTs), intravenous fentanyl (1 RCT), intravenous lidocaine (1 RCT), oral venlafaxine (1 RCT) and inhaled nitrous oxide (1 RCT). Meta‐analysis suggested a modest but statistically significant reduction in the incidence of chronic pain after surgery following treatment with ketamine but not gabapentin or pregabalin. Results with ketamine should be viewed with caution since most of the included trials were small (that is
Mención de responsabilidad :	Chaparro LE, Smith SA, Moore RA, Wiffen PJ, Gilron I
Referencia :	Cochrane Database Syst Rev. 2013 Jul 24;(7):CD008307.
DOI (Digital Object Identifier) :	10.1002/14651858.CD008307.pub2
En línea :	https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008307.pub2/full
Enlace permanente :	https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3718