Efectividad de la analgesia multimodal para reducir el consumo de opioides y mejorar la recuperación posoperatoria después de cirugía abdominal
DOI:
https://doi.org/10.5281/zenodo.23205321Palabras clave:
recuperación, dolor posoperatorio, opioides, cirugía abdominal, analgesia multimodalResumen
La analgesia multimodal busca controlar dolor y reducir exposición a opioides tras cirugía abdominal. Se realizó una revisión narrativa crítica de ensayos, metaanálisis y recomendaciones específicas por procedimiento. Se distinguieron consumo farmacológico, analgesia, recuperación y seguridad. La evidencia muestra beneficios variables según componente y contexto; el ahorro de opioides no garantiza mejoría funcional. El ensayo ALLEGRO no demostró mejor recuperación intestinal con lidocaína, y la evidencia amplia no respalda gabapentinoides rutinarios. Se propone una matriz de selección y continuidad perioperatoria. Se concluye que la estrategia debe individualizarse, conservar rescate analgésico y evaluar función y efectos adversos, evitando combinaciones acumulativas sin beneficio demostrado.
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Referencias
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