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dc.contributor.advisorOchoa Vera, Miguel Enrique
dc.contributor.advisorChona Vásquez, Jorge Enrique
dc.contributor.authorHernández Gutiérrez, Daniel Enrique
dc.date.accessioned2020-06-26T19:47:56Z
dc.date.available2020-06-26T19:47:56Z
dc.date.issued2016
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1624
dc.description.abstractLa sedoanalgesia previa a anestesia regional oftálmica es utilizada comúnmente para reducir la ansiedad, el malestar y el dolor asociados con la punción ocular; aunque podría causar disminución de la cooperación del paciente. Se buscó evaluar el nivel de satisfacción que presenta el método de sedoanalgesia con propofol y fentanilo previo a anestesia regional oftálmica para cirugía de catarata. Se midieron como variables de resultado la analgesia por EVA, amnesia a la punción ocular, la satisfacción del anestesiólogo y del cirujano respecto a la sedoanalgesia, la satisfacción del paciente respecto a la misma por EISA. La hipótesis consistió en que las variables de resultado debían tener valores favorables respecto al procedimiento en más del 90% de los casos. Se estudiaron 93 pacientes intervenidos por cirugía de catarata con anestesia regional oftálmica previa utilización de sedoanalgesia con propofol y fentanilo en la Fundación Oftalmológica de Santander. Se realizó un análisis univariado para probar las hipótesis propuestas y un análisis bivariado exploratorio para indagar acerca de asociaciones entre covariables. Se encontró que el 90.32% de los pacientes obtuvo un puntaje mayor a 2 en la escala EISA y para todos los ítems de la escala EISA el porcentaje de pacientes satisfechos no fue significativamente menor de 90%. El 76% de los pacientes presentaron amnesia a la punción siendo la única variable de resultado cuyo porcentaje de desenlace favorable fue significativamente menor de 90%.spa
dc.description.tableofcontentsINTRODUCCIÓN 19 1. MARCO TEÓRICO 22 1.1 ASPECTOS FARMACOLÓGICOS 22 1.2 SEDOANALGESIA PREVIA A PROCEDIMIENTOS 24 1.3 MEDICIÓN DEL NIVEL DE SEDACIÓN, DOLOR Y SATISFACCIÓN CON EL ACTO ANESTÉSICO 25 1.4 ANESTESIA REGIONAL OFTÁLMICA 28 1.5 CIRUGÍA DE CATARATA 30 2. ANTECEDENTES 32 3. METODOLOGÍA 40 3.1 POBLACIÓN Y MUESTRA 40 3.1.1 Tamaño de muestra mínimo 43 3.2 HIPÓTESIS 44 3.3 DISEÑO GENERAL DE LA INVESTIGACIÓN 46 3.4 DEFINICIÓN Y OPERACIONALIZACIÓN DE LAS VARIABLES 48 3.5 PROCESAMIENTO DE LOS DATOS Y ANÁLISIS ESTADÍSTICO 53 4. RESULTADOS 55 4.2 ANÁLISIS UNIVARIADO 56 4.3 ANÁLISIS EXPLORATORIO BIVARIADO 69 4.3.1 Edad. 72 4.3.2 Peso 78 4.3.3 Dosis Fentanilo 85 4.3.4 Dosis Propofol 92 4.3.5 Dolor por EVA inmediato 97 4.3.6 Dolor por EVA posoperatorio 99 4.3.7 Duración 100 4.3.8 Laten 109 4.3.9 Género 113 4.3.10 Nivel ASA 115 4.3.11 Escala de sedación de Ramsay 115 4.3.12 Anestesiólogo 117 4.3.13 Residente Anestesiología 117 4.3.14 Recuerdo a la punción 119 4.3.15 Satisfacción de Anestesiól 120 4.3.15 Satisfacción de Cirujano 123 4.3.17 Ítems de la escala de satisfacción anestésica EISA 124 4.4 CONSIDERACIONES ADICIONALES 126 5. CONCLUSIONES 133 REFERENCIAS 134 ANEXO 141spa
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleSatisfacción frente a la sedoanalgesía con proponol y fentanilo previa a punción anestésica oftálmica para cirugía de catarataspa
dc.title.translatedSatisfaction against sedoanalgesia with proponol and fentanyl prior to ophthalmic anesthetic puncture for cataract surgeryeng
dc.degree.nameEspecialista en Anestesiología
dc.coverageBucaramanga (Santander, Colombia)
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNAB
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Salud
dc.publisher.programEspecialización en Anestesiología
dc.description.degreelevelEspecialización
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsCataracts (Ophthalmology)
dc.subject.keywordsEye surgery
dc.subject.keywordsAnesthesia in ophthalmology
dc.subject.keywordsMedicine
dc.subject.keywordsAnesthesiology
dc.subject.keywordsInvestigations
dc.subject.keywordsAnalysis
dc.subject.keywordsSatisfaction
dc.subject.keywordsFentanyl
dc.subject.keywordsOphthalmic regional anaesthesia
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponamereponame:Repositorio Institucional UNAB
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2
dc.relation.referencesHernández Gutiérrez, Daniel Enrique, Chona Vásquez (2016). Satisfacción frente a la sedoanalgesía con proponol y fentanilo previa a punción anestésica oftálmica para cirugía de catarata. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB
dc.relation.references1. Van Zundert A, Kumar C. Ophthalmic loco-regional anaesthesia: Reducing discomfort during injection. SAJAA. 2008; 14(2): p. 25-28.
dc.relation.references2. Janzen P, Christys A, Vucevic M. Patient-controlled sedation using propofol in elderly patients in day-case cataract surgery. Br J Anaesth. 1999; 82: p. 635-6.
dc.relation.references3. Brian G, Tylor H. Cataract blindness-challenges for the 21st century. Bulletin of the World Health Organization. 2001; 79: p. 249-256.
dc.relation.references4. Campbell D, Lim M, Kerr Muir M, O’Sullivan G, Falcon M, Fison Pet. A prospective randomised study of local versus general anaesthesia for cataract surgery. Anaesthesia. 1993; 48: p. 422–428.
dc.relation.references5. Boezaart A, Berry R, Laudscher , Nell M. Evaluation of anxiolysis and pain associated with combined peri and retrobulbar eye block for cataract surgery. J Clin Anesth. 1998; 10: p. 204-10.
dc.relation.references6. Donlon JJ, Doyle D, Feldman M. Anesthesia for eye, ear, nose and throat surgery. In Miller's anestesia. Philadelphia: Churchill Livingstone Inc; 2005. p. 65.
dc.relation.references7. Greenhalgh D, Kumar C. Sedation during ophthalmic surgery. Eur J Anaesthesiol. 2008 Sep; 25(9): p. 701-7.
dc.relation.references8. Gilbert J, Holt J, Johnston J, Sabo B, Weaver J. Intravenous sedation for cataract surgery. Anaesthesia. 1987; 42: p. 1063-1069.
dc.relation.references9. Royal College of Anaesthetists and Royal College of Ophthalmologists. Local anaesthesia for ophthalmic surgery. Joint guidelines; 2012.
dc.relation.references10. Bellucci R. Anesthesia for cataract surgery. Curr Opin Ophthalmol. 1999 Feb; 10(1): p. 36-41.
dc.relation.references11. Yağan Ö, Karakahya R, Taş N, Küçük A. Comparison of dexmedetomidine versus ketamine-propofol combination for sedation in cataract surgery. Turk J Anaesth Reanim. 2015; 43: p. 84-90.
dc.relation.references12. Beatie C, Stead S. Effects of propofol sedation for ophthalmic nerve blocks [abstract]. Anesthesiology. 1991; 75: p. A28.
dc.relation.references13. Inan U, Sivac R, Ermis S, Ozturk F. Effects of fentanyl on pain and hemodynamic response after retrobulbar block in patients having phacoemulsification. J Cataract Refract Surg. 2003; 29(6): p. 1137-42.
dc.relation.references14. Barr J. Propofol: a new drug for sedation in the intensive care unit. Int Anesthesiol Clin. 1995; 33(1): p. 131-54.
dc.relation.references15. Brunton L, Chabner B, Knollmann. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed.: McGraw Hill; 2011.
dc.relation.references16. Zacny J, Coalson D, Young C, Klafta J, Lichtor J, Rupani G, et al. Propofol at conscious sedation doses produces mild analgesia to cold pressor-induced pain in healthy volunteers. J Clin Anesth. 1996 Sep; 8(6): p. 469-74.
dc.relation.references17. Lauretti G, Lauretti C, Lauretti-Filho A. Propofol decreases ocular pressure in outpatients undergoing trabeculectomy. J. Clin. Anesth. 1997; 9(4): p. 289-92.
dc.relation.references18. Steinbacher D. Propofol: A sedative-hypnotic anesthetic agent for use in ambulatory procedures. Anesth Prog. 2001; 48: p. 66-71.
dc.relation.references19. Barker J, Robinson P, Vafidis G, Hart G. Local analgesia prevents the cortisol and glycemic response to cataract surgery. Br J Anesth. 1990; 64: p. 442-5.
dc.relation.references20. Young-McCaughan S, Miaskowski C. Definition of and mechanism for opioid-induced sedation. Pain Manag Nurs. 2001 Sep; 2(3): p. 84-97.
dc.relation.references21. Villarejo-Diaz M, Murillo-Zaragoza J, Alvarado-Hernandez H. Farmacología de los agonistas y antagonistas de los receptores opioides. Educación e investigación clínica. 2000; 1(2): p. 106-137.
dc.relation.references22. Tobias J, Leder M. Procedural sedation: A review of sedative agents, monitoring, and manegement of complications. Saudi J Anaesth. 2011; 5(4): p. 395-410.
dc.relation.references23. Tao J, Nunery W, Kresovsky S, Lister L, Mote T. Efficacy of fentanyl or alfentanil in suppressing reflex sneezing after propofol sedation and periocular injection. Ophtal Plast Reconstr Surg. 2008; 24(6): p. 465-467.
dc.relation.references24. Celiker V, Basgul E, Sahin A, Uzun S, Bahadir B, Aypar U. Comparison of midazolam, propofol and fentanyl combinations for sedation and hemodynamic parameters in cataract extraction. Saudi Med J. 2007 Aug; 28(8): p. 1198-203.
dc.relation.references25. Holas A, Kraff P, Marcovic M, Quehenberger F. Remifentanil, propofol or both for conscious sedation during eye surgey under regional anaesthesia. European Journal of Anaesthesiology. 1999; 16: p. 741-748.
dc.relation.references26. Borgeat A, Wilder-Smit O, Suter P. The non-hypnotic therapeutic applications of propofol. Anesthesiology. 1994; 80: p. 642-56.
dc.relation.references27. Herrick I, Gelb A, Nichols B, Nichols J. Patient-controlled propofol sedation for elderly patients: safety and patient attitude toward control. Can. J. Anaesth. 1996; 43(10): p. 1014-8.
dc.relation.references28. Hertzog J, J C, Hauser G. Propofol anesthesia for invasive procedures in ambulatory and hospitalized children: Experience in the pediatric intensive care unit. Pediatrics. 1999;: p. 103-130.
dc.relation.references29. Rosenberg M, Raymond C, Bridge P. Comparison of midazolam/ketamine with methohexital for sedation during peribulbar block. Anesth Analg. 1995; 81: p. 173–174.
dc.relation.references30. Salmon J, Mets B, James M, Murray A. Intravenous sedation for ocular surgery under local anaesthesia. Br J Ophthalmol. 1992; 76: p. 598-601.
dc.relation.references31. Sessler C, Grap M, Ramsay M. Evaluating and monitoring analgesia and sedation in the intensive care unit. Crit Care. 2008; 12(Suppl 3): p. S2.
dc.relation.references32. Mera MJF, Moya AG, Sánchez MEE, Álvarez JR, Ramos AMC, Chorro BB, et al. Análisis de 4 escalas de valoración de la sedación en el paciente crítico. Enferm Intensiva. 2009; 20(3): p. 88-94.
dc.relation.references33. Ramsay M, Savege T, Simpson B, Goodwin R. Controlled sedation with alphaxalone-alphadolone. BMJ. 1974;: p. 656-659.
dc.relation.references34. Frade M, Guirao A, Esteban M, Rivera J, Cruz A, Bretones B, et al. Análisis de 4 escalas de valoración de la sedación en el paciente crítico. Enferm Intensiva. 2009; 20(3): p. 88-94.
dc.relation.references35. Ely E, Truman B, Shintani A, Thomason J, Wheeler A, Gordon S. Monitoring sedation status over time in ICU patients. JAMA. 2003; 289(22): p. 2983-2991.
dc.relation.references36. Bergh I, Sjostrom B, Oden A, Steen B. An application of pain rating scales in geriatric patients. Aging (Milano). 2000; 12: p. 380-387.
dc.relation.references37. Puntillo K, White C, Morris A, Perdue S, Stanik-Hutt J, Thompson C, et al. Patients’ perceptions and responses to procedural pain: results from Thunder Project II. Am J Crit Care. 2001; 10: p. 238-251.
dc.relation.references38. MacPherson R. Structured assessment tool to evaluate patient suitability for cataract surgery under local anaesthesia. British Journal of Anaesthesia. 2004; 93: p. 521–524.
dc.relation.references39. Watts M, Pearce J. Day case cataract surgery. Br J Ophthalmol. 1988; 72: p. 879-899.
dc.relation.references40. Dexter F, Aker J, Wright W. Development of a measure of patient satisfaction with monitored anesthesia care. The Iowa satisfaction with anestesia scale. Anesthesiology. 1997; 87: p. 865-873.
dc.relation.references41. Jimenez L, Del Real A. Validación al español de la escala "The Iowa satisfaction with anesthesia scale (ISAS)" para cuidado anestésico monitorizado en cirugía oftalmológica. Revista Colombiana de Anestesiología. 2014; 42(4): p. 272-280.
dc.relation.references42. Maurice-Szamburski A, Bruder N, Loundou A, Capdevila X, Auquier P. Development and validation of a perioperative satisfaction questionnaire in regional anesthesia. Anesthesiology. 2013; 118: p. 78-87.
dc.relation.references43. Chanthong P, Abrishami A, Wong J, Herrera F, Chung F. Systematic review of questionnaires measuring patient satisfaction in ambulatory anesthesia. Anesthesiology. 2009;(110): p. 1061–7.
dc.relation.references44. Nielsen P, Allerod C. Evaluation of local anesthesia techniques for small incision cataract surgery. Cataract Refract Surg. 1998; 24: p. 1136–1144.
dc.relation.references45. Davis DI, Mandel M. Posterior peribulbar anaesthesia: an alternative to retrobulbar anaesthesia. J Cataract Refract Surg. 1986; 12: p. 182–184.
dc.relation.references46. McLure M, Rubin A. Review of local anaesthetic agents. Minerva Anestesiologica. 2005; 71: p. 59-74.
dc.relation.references47. Hamilton R, Gimbel H, Strunin L. Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures. Can J Anaesth. 1988; 35: p. 615-623.
dc.relation.references48. Schulenburg H, Sri-Chandana C, Lyons G, Columb M, McLure H. Hyaluronidase reduces local anaesthetic volumes for sub-Tenon’s anaesthesia. Br J Anaesth. 2007; 99: p. 717-720.
dc.relation.references49. Lumme P, Laatikainen L. Sociodemographic aspects and systemic diseases of cataract patients. Acta Opthalmol Scand. 1994; 72: p. 79–85.
dc.relation.references50. Furtado J, Lansngh V, Yaacov F, Yee M, Barría F. Guia práctica de catarata senil para latinoamérica; 2012.
dc.relation.references51. Jimenez-Benito J, Loscos-Arenas J, Moser C, Ferrran M, Cámara J. Actualización en la cirugía extracapsular de catarata, túnel escleral y extracción de la catarata mediante “técnica del anzuelo”. Annals D'oftamologia. 2012; 20 (2).
dc.relation.references52. Henning A, Kumar J, Yorston D. Sutureless catataract surgery with nucleus extraction: outcome of a prospective study in Nepal. Br J Ophthalmol. 2003; 87: p. 266-70.
dc.relation.references53. Ferrari L, Donlon J. A comparison of propofol, midazolam, and methohexital for sedation during retrobulbar and peribulbar block. J Clin Anesth. 1992; 4: p. 93–96.
dc.relation.references54. Yee J, Schafer P, Crandall A, Pace N. Comparison of methohexital and alfentanil on movement during placement of retrobulbar nerve block. Anesth Analg. 1994; 79: p. 320–323.
dc.relation.references55. Yee J, Burns T, Mann J, Crandall A. Propofol and alfentanil for sedation during placement of retrobulbar block for cataract surgery. J Clin Anesth. 1996; 8(8): p. 623-626.
dc.relation.references56. Wong D, Merick P. Intravenous sedation prior to peribulbar anaesthesia for cataract surgery in elderly patients. Can J Anaesth. 1996; 43: p. 1115–1120.
dc.relation.references57. Pac-Soo C, Deacock S, Lockwood G, Carr C, Whitwam J. Patient-controlled sedation for cataract surgery using peribulbar block. Br. J. Anaesth. 1996; 77(3): p. 370-4.
dc.relation.references58. McHardy F, Fortier J, Chung F, Krishnathas A, Marshal S. A comparion of midazolam, alfentanil and propofol for sedation in outpatient intraocular surgery. Canadiean Joural of Anesthesia. 2000; 47(3): p. 211-214.
dc.relation.references59. Hocking G, Balmer H. A single sub-anaesthetic dose of propofol to reduce patient recall of peribulbar block. JR Army Med Corps. 2000; 146: p. 196–198.
dc.relation.references60. Rewari V, Madan R, Kaul H, Kumar L. Remifentanil and propofol sedation for retrobulbar nerve block. Anaesth Intensive Care. 2002 Aug; 30(4): p. 433-7.
dc.relation.references61. Habib N, Balmer H, Hocking G. Efficacy and safety of sedation with propofol in peribulbar anaesthesia. Eye. 2002; 16: p. 60-62.
dc.relation.references62. Dal D, Demirtas M, Sahin A, Aypar U, Irkec M. Remifentanil versus propofol sedation for peribulbar anesthesia. Middle East J Anaesthesiol. 2005 Oct; 18(3): p. 583-93.
dc.relation.references63. Santiveri X, Molto L, Rodríguez C, Sandín F, Vilaplana J, Castillo J. Sedoanalgesia con propofol-ketamina a bajas dosis para la práctica del bloqueo retrobulbar. Rev. Esp. Anestesiol. Reanim. 2006; 53: p. 545-549.
dc.relation.references64. Maghsoudi B, Talebnejad M, Asadipour E. Analgesia for retrobulbar block – Comparison of Remifentanil, Alfentanil and Fentanyl. M.E. J. Anesth. 2007; 19 (3).
dc.relation.references65. Okasha H, Hamd W, Obaya G, Salama A, Mohamad M. Dexmedetomidine versus propofol for sedation in patients undergoing vitero-retinal surgery under peribulbar block. Med. J. Cairo Univ. 2016; 84(2): p. 211-217.
dc.description.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000898465
dc.identifier.orcidhttps://orcid.org/0000-0002-4552-3388
dc.description.scopushttps://www.scopus.com/authid/detail.uri?authorId=36987156500
dc.description.researchgatehttps://www.researchgate.net/profile/Miguel_Ochoa7
dc.subject.lembCataratas (Oftalmología)spa
dc.subject.lembCirugía de los ojosspa
dc.subject.lembAnestesia en oftalmologíaspa
dc.subject.lembMedicinaspa
dc.subject.lembAnestesiologíaspa
dc.subject.lembInvestigacionesspa
dc.subject.lembAnálisisspa
dc.description.abstractenglishSedoanalgesia previous ophthalmic regional anaesthesia is commonly used to reduce anxiety, pain and discomfort which are associated with ocular puncture. Even though it could cause patient cooperation reduced. This survey assess the satisfaction level of sedoanalgesia with Propofol and Fentanyl previous an ophthalmic regional anaesthesia for cataract surgery method. This research measured pain about ocular puncture on a verbal analogue scale, ocular puncture amnesia, anesthetist and surgeon satisfaction with sedoanalgesia and also patient's satisfaction by EISA. The hypothesis consisted on variables had favorable values in more than 90 percent of cases. This investigation run a univariate analysis to test hypothesis propounded and a multivariate exploratory analysis to search associations between covariates. We studied 93 patients who had cataract surgery with ophthalmic regional anaesthesia previous sedoanalgesia with Propofol and Fentanyl in the Fundación Oftalmológica de Santander. We found 90,32% of patients obtained a satisfaction value higher than 2 in EISA, and all variables except for ocular puncture amnesia were near to 90 percent of successful cases. Only 76% percent of patients had ocular puncture amnesia, like ocular puncture amnesia reported in the literature.eng
dc.subject.proposalSatisfacción
dc.subject.proposalSedoanalgesia
dc.subject.proposalFentanilo
dc.subject.proposalPropofol
dc.subject.proposalAnestesia regional oftálmica
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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