Fisiología de dolor y analgesia multimodal en el paciente crítico.

CRITICAL CARE & EMERGENGY MEDICINE VOL. 3

 Pain physiology and multimodal analgesia in the critical patient.

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 https://doi.org/10.58281/ccem24051701

Gastón Daniel Martínez Sedas 1 .

1Médico Anestesiólogo. Médico Especialista en Medicina Crítica. Residente de Medicina de Dolor y Cuidados Paliativos, Hospital General de
México “Dr. Eduardo Liceaga”, UNAM  

Abstract

Introduction: Pain in the Intensive Care Unit is a frequent entity, although very little evaluated and incorrectly treated by professionals in this area of medicine, despite being considered the fifth vital sign and its presence directly impacts the evolution of the critically ill patient. . Much of the incorrect interpretation of this phenomenon is due to lack of knowledge in its objective evaluation since less than 50% of intensive care professionals evaluate pain, mainly due to little training in this regard.
Understanding the mechanisms of generation of the painfulstimulus, the assessment methods and knowing different analgesic treatment strategies could allow us to offer our patients appropriate interventions and not only limit ourselves to analgesics such as opioids or routes of administration such as intravenous, since the approach Multimodal offers different useful alternatives in the intensive care unit, improving the quality of analgesia and the adverse effects of different analgesics due to their overdose.
A review of the current literature on this topic was carried out in search engines such as PubMed and databases such as UpToDate, Clinikal Key, SpringerLink, ScienceDirect, with the main search titles being analgesia in critically ill patients, multimodal analgesia and regional analgesia and anesthesia techniques in the critical patient resulting in the following article with great evidence compiled.

Introducción: El dolor en la Unidad de Cuidados Intensivos es una entidad frecuente, aunque muy poco evaluada e incorrectamente tratada por profesionales de esta área de la medicina, a pesar de ser considerado el quinto signo vital y que su presencia impacta directamente en la evolución del paciente crítico.
Gran parte de la incorrecta interpretación de este fenómeno es por el desconocimiento en la evaluación objetiva del mismo ya que menos del 50% de los profesionales de cuidados intensivos evalúan el dolor principalmente por la poca capacitación al respecto.
Comprender los mecanismos de generación del estímulo doloroso, los métodos de valoración y conocer diferentes estrategias de tratamiento analgésico podría lograr que podamos ofertar a nuestros pacientes adecuadas intervenciones y no solo limitarnos a analgésicos como los opioides o a vías de administración como la intravenosa ya que el abordaje multimodal ofrece diferentes alternativas útiles en la unidad de cuidados intensivos mejorando la calidad de la analgesia y los efectos adversos de diferentes analgésicos por sobredosificación de los mismos.
Se hizo una revisión de la literatura actual de este tema en buscadores como PubMed y bases de datos como UpToDate, Clinikal Key, SpringerLink, ScienceDirect teniendo como principales títulos de búsqueda analgesia en el paciente crítico, analgesia multimodal y técnicas de analgesia y anestesia regional en el paciente crítico teniendo como resultado el siguiente artículo con una gran evidencia recopilada.

Gluteal lipoinjection, pulmonary fat embolism, macroscopic fat embolism, microscopic fat embolism, right ventricular fai- lure, liposuction.

Gastón Daniel Martínez Sedas .
Médico Anestesiólogo. Médico Especialista en Medicina Crítica. Residente de Medicina de Dolor y Cuidados Paliativos, Hospital General de
México “Dr. Eduardo Liceaga”, UNAM  

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[1] [14] Gastón Daniel Martínez Sedas. 2024. Fisiología de dolor y analgesia multimodal en el paciente crítico. CRITICAL CARE & EMERGENCY MEDICINE. Vol. 3, pp. 1–12. DOI: https://doi.org/10.58281/ccem24051701.
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2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

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