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dc.contributor.advisorChona Vásquez, Jorge Enriquespa
dc.contributor.advisorMeléndez Flórez, Héctor Juliospa
dc.contributor.authorRangel Miranda, Francy Lissethspa
dc.date.accessioned2020-06-26T19:47:58Z
dc.date.available2020-06-26T19:47:58Z
dc.date.issued2018
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1630
dc.description.abstractUno de los síntomas más frecuentes y desagradables en la UCPA ( Unidad de Cuidado Postanestésico) son las náuseas y vómitos postoperatorios (NVPOP). La incidencia general de vómito es alrededor del 30% y la incidencia de náuseas alrededor del 50%, y en pacientes del alto riesgo las NVPOP puede ser tan alta como el 80%(1). A pesar de que los tiempos de ayuno han disminuido en los últimos años y es permitido la ingesta de líquidos claros hasta 2 horas antes de la cirugía, en la mayoría de servicios de anestesiología del mundo los pacientes tienen un ayuno prolongado de más de 12 horas (2,3,4). El ayuno prolongado puede tener efectos fisiológicos adversos como sed, hambre, somnolencia o mareos, ya que el ayuno, al igual que el trauma o la cirugía, es un importante liberador de hormonas de estrés y de mediadores inflamatorios. Todas ellas generan una respuesta catabólica caracterizada en mayor o menor grado por deshidratación, hiperglucemia postoperatoria, resistencia a la insulina, desgaste muscular y una respuesta inmunológica deprimida (3,4). Existe una amplia literatura sobre factores de riesgo para NVPOP, pero al realizar la búsqueda bibliográfica con el tiempo de ayuno la literatura es inconclusa (1,5,6,7). El objetivo principal del estudio fue determinar si el ayuno prolongado era factor de riesgo independiente para la presentación de NVPOP en pacientes llevados a cirugía electiva, Se ensambló una cohorte de 292 pacientes, se realizó un análisis descriptivo, bivariado y multivariado, en el cual se realizó un modelo final mediante regresión binomial y modelaje. La hipótesis final fue determinar la relación entre ayuno preoperatorio prolongado y la presentación de NVPOP, la cual no se pudo comprobar. Pero se evidenció mayor riesgo absoluto para NVPOP con ayuno prolongado en general con un RR de 1.96 y un IC 95% (0.54 – 7.18) p 0.308, al igual que el ayuno prolongado para sólidos con RR de 3,08 y un IC 95% (0,47 – 20,19) p 0,24, sin significancia estadística. En el modelo final, quedaron incluidas 3 variables estadísticamente significativas de las cuales 1 se asocio como factor protector Anestesia regional RR 0,395 y 2 variables que se comportaron como factor de riesgo para NVPOP. Como el uso de propofol durante la inducción anestésica con RR 4,075 y el sexo femenino con un RR 2,094 veces .spa
dc.description.tableofcontents1. RESUMEN DEL PROYECTO …………………………………………………….8 2. DESCRIPCIÓN DEL PROYECTO………………………………………...........9 2.1 PLANTEAMIENTO DEL PROBLEMA DE INVESTIGACIÓN…………….9 2.2 JUSTIFICACIÓN …………………………………………………………….10 2.3 HIPÓTESIS ……………………………………………………………........11 2.4 PALABRAS CLAVE..……………………………………………………….11 3. OBJETIVOS……………………………………………………………………...11 3.1 Objetivo General…………………………………………………………….11 3.2 Objetivos específicos……………………………………………………….11 4. MARCO TEÓRICO………………………………………………………………12 5. METODOLOGIA PROPUESTA ……………………………………………….25 5.1 Tipo y diseño general del estudio …………………………………………25 5.2 Lugar donde se realializó la investigación………………………………...25 5.3 Tiempo de ejecución del trabajo……………………………………………25 5.4 Población elegible …………………………………………………………..26 5.5 Criterios de inclusión y excusión …………………………………………..26 5.6 Tamaño muestral ……………………………………………………………27 6. RECOLECCIÓN DE LA INFORMACIÓN Y VARIABLES…………………..27 6.1 Definición de variables ……………………………………………………...27 6.2 Recolección de la información …………………………………………….31 7. PLAN DE ANÁLISIS ……………………………………………………………32 8. CONSIDERACIONES ÉTICAS ………………………………………………..33 9. CRONOGRAMA ………………………………………………………………...34 10. RECURSOS Y PRESUPUESTO………………………………………………34 11. RESULTADOS FINALES ……………………………………………………...35 12. DISCUSION DE RESULTADOS ………………………………………………50 13. CONCLUSIONES ……………………………………………………………….54 14. PLAN DE DIVULGACIÓN DE DATOS……………..…………………………55 15. REFERENCIAS BIBLIOGRÁFICAS ………………………………………….56 16. ANEXOS………………………………………………………………………….61 16.1 Variables independientes ……………………………………………….61 16.2 Consentimiento informado ……………………………………………..63 16.3 Formato de recolección de datos ……………………………………...65 16.4 Flujograma de recolección de datos …………………………………..67 16.5 Cronograma de actividades …………………………………………….68 16.6 Recursos y presupuesto. ……………………………………………….69 16.7 Carta de aprobación comité de ética ………………………………….71spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleAyuno prolongado y riesgo de náuseas y vómito postoperatoriospa
dc.title.translatedProlonged fasting and risk of postoperative nausea and vomitingeng
dc.degree.nameEspecialista en Anestesiologíaspa
dc.coverageBucaramanga (Santander, Colombia)spa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programEspecialización en Anestesiologíaspa
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsAnesthesia (Complications)eng
dc.subject.keywordsPostoperative complicationseng
dc.subject.keywordsPostoperative nausea and vomitingeng
dc.subject.keywordsRisk factorseng
dc.subject.keywordsMedicineeng
dc.subject.keywordsAnesthesiologyeng
dc.subject.keywordsInvestigationseng
dc.subject.keywordsAnalysiseng
dc.subject.keywordsFasteng
dc.subject.keywordsCatabolic responseeng
dc.subject.keywordsGastric contenteng
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
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dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000320609*
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001613255*
dc.contributor.orcidhttps://orcid.org/0000-0003-1791-8099*
dc.subject.lembAnestesia (Complicaciones)spa
dc.subject.lembComplicaciones posoperatoriasspa
dc.subject.lembNáusea y vómito postoperatoriospa
dc.subject.lembFactores de riesgospa
dc.subject.lembMedicinaspa
dc.subject.lembAnestesiologíaspa
dc.subject.lembInvestigacionesspa
dc.subject.lembAnálisisspa
dc.description.abstractenglishOne of the most frequent and unpleasant symptoms in the PACU (Postanesthetic Care Unit) is postoperative nausea and vomiting (NVPOP). The overall incidence of vomiting is around 30% and the incidence of nausea around 50%, and in high-risk patients NVPOP can be as high as 80% (1). Although fasting times have decreased in recent years and clear liquids are allowed up to 2 hours before surgery, in most anesthesiology services in the world patients have a prolonged fast of more than 12 hours (2,3,4). Prolonged fasting can have adverse physiological effects such as thirst, hunger, drowsiness or dizziness, since fasting, like trauma or surgery, is an important releaser of stress hormones and inflammatory mediators. All of them generate a catabolic response characterized to a greater or lesser degree by dehydration, postoperative hyperglycemia, insulin resistance, muscle wasting, and a depressed immune response (3,4). There is an extensive literature on risk factors for NVPOP, but when conducting the literature search with fasting time, the literature is inconclusive (1,5,6,7). The main objective of the study was to determine if prolonged fasting was an independent risk factor for the presentation of NVPOP in patients undergoing elective surgery. A cohort of 292 patients was assembled, a descriptive, bivariate and multivariate analysis was performed, in which performed a final model using binomial regression and modeling. The final hypothesis was to determine the relationship between prolonged preoperative fasting and the presentation of NVPOP, which could not be verified. But a higher absolute risk for NVPOP was evidenced with prolonged fasting in general with a RR of 1.96 and a 95% CI (0.54 - 7.18) p 0.308, as well as prolonged fasting for solids with a RR of 3.08 and a 95% CI (0.47 - 20.19) p 0.24, without statistical significance. In the final model, 3 statistically significant variables were included, of which 1 was associated as a protective factor Regional anesthesia RR 0.395 and 2 variables that behaved as a risk factor for NVPOP. Such as the use of propofol during anesthetic induction with RR 4.075 and female sex with RR 2.094 times.eng
dc.subject.proposalAyuno
dc.subject.proposalRespuesta catabólica
dc.subject.proposalContenido gástrico
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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