<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1652-6776</journal-id>
<journal-title><![CDATA[Cuadernos Hospital de Clínicas]]></journal-title>
<abbrev-journal-title><![CDATA[Cuad. - Hosp. Clín.]]></abbrev-journal-title>
<issn>1652-6776</issn>
<publisher>
<publisher-name><![CDATA[Universidad Mayor de San Andrés, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1652-67762024000200031</article-id>
<article-id pub-id-type="doi">10.53287/aprt7386ms61g</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Eficacia analgésica de la morfina intratecal como complemento en la anestesia raquídea para cirugía cesárea]]></article-title>
<article-title xml:lang="en"><![CDATA[Analgesic efficacy of intrathecal morphine as an adjunct to spinal anesthesia for cesarean surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ameller-Mendizabal]]></surname>
<given-names><![CDATA[Victor D. L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira-Gorena]]></surname>
<given-names><![CDATA[Magdiel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,aff1  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,aff2  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>65</volume>
<numero>2</numero>
<fpage>31</fpage>
<lpage>37</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1652-67762024000200031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1652-67762024000200031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1652-67762024000200031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: El control del dolor post-cesárea, es importante para proveer a la puérpera de movilización precoz, para una recuperación rápida, de los más estudiados es la morfina, el cual muestra un perfil seguro de acción, dependiente de la dosis.  Objetivo: Determinar la eficacia analgésica de la morfina intratecal como complemento en la anestesia raquídea para cirugía cesárea, en Hospital &#8220;Dr. Jorge Eduardo Olmos Maeda&#8221; San Borja - Beni de julio a septiembre del 2020.  Metodología: Se realizó un ensayo clínico aleatorizado a ciegas con el propósito de evaluar la eficacia analgésica y seguridad de la administración de morfina intratecal (MIT) en la analgesia posoperatoria tras las intervenciones cesárea en el Hospital &#8220;Dr. Jorge Eduardo Olmos Maeda&#8221; San Borja - Beni en el periodo de julio - septiembre del 2020 Universo: conformado por las pacientes programadas para cesárea, se analizaron también variables como peso, edad, frecuencia de eventos adversos atribuibles al uso de opioides.  Resultados: La presencia de dolor fue más frecuente en el grupo (A) que recibió dosis de 1 µgr/ kg de morfina intratecal (8/45); que en el grupo (B) que recibió dosis de 2 µgr/kg de morfina intratecal (0/45), en contraparte el grupo A, presento menores efectos adversos a opioides (3/45), que el grupo B (10/45).  Conclusiones: El uso de morfina intratecal, es seguro, de acuerdo a los resultados obtenidos, pero es más recomendable el uso de 1 µgr/kg, por su buen control analgésico y frecuencia disminuida de reacciones adversas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Post-cesarean pain control is important to facilitate early mobilization and rapid recovery for postpartum women.  Objective: To determine the analgesic efficacy of intrathecal morphine as a complement to spinal anesthesia for cesarean surgery at the Jorge Maeda Hospital in San Borja (Beni) from July to September 2020.  Methodology: We conducted a double-blind randomized clinical trial to evaluate the analgesic efficacy and safety of intrathecal morphine (ITM) for postoperative pain management following cesarean interventions at the Jorge Maeda Hospital in San Borja (Beni) during the period from July to September 2020. The study population consisted of patients scheduled for cesarean section.  Results: Pain was more frequent in Group A, which received a dose of 1 µg/kg intrathecal morphine (8/45), compared to Group B, which received a dose of 2 µg/kg intrathecal morphine (0/45). However, Group A had fewer adverse effects related to opioids (3/45) compared to Group B (10/45).  Conclusions: The use of intrathecal morphine is safe. Based on the results obtained, a dose of 1 µg/kg is more recommendable due to its effective pain control and reduced frequency of adverse reactions.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cesárea]]></kwd>
<kwd lng="es"><![CDATA[Morfina intratecal]]></kwd>
<kwd lng="es"><![CDATA[Control de dolor]]></kwd>
<kwd lng="es"><![CDATA[Anestesia Raquídea]]></kwd>
<kwd lng="en"><![CDATA[Cesarean section]]></kwd>
<kwd lng="en"><![CDATA[Intrathecal morphine]]></kwd>
<kwd lng="en"><![CDATA[Pain control]]></kwd>
<kwd lng="en"><![CDATA[Spinal anesthesia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Domke P.]]></surname>
<given-names><![CDATA[Robert]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras-Domínguez]]></surname>
<given-names><![CDATA[Víctor]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras Chassin-Trubert]]></surname>
<given-names><![CDATA[Felipe]]></given-names>
</name>
<name>
<surname><![CDATA[Carbonell-Bellolio]]></surname>
<given-names><![CDATA[Paulina]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo del dolor agudo postoperatorio en operación cesárea]]></article-title>
<source><![CDATA[Revista chilena de obstetricia y ginecología]]></source>
<year>2018</year>
<volume>83</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>635-42</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mishriky]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[George]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Habib]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis]]></article-title>
<source><![CDATA[Can J Anaesth]]></source>
<year></year>
<numero>59</numero>
<issue>59</issue>
<page-range>766-78</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chandon]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnet]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Burg]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Barnichon]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[DesMesnards-Smaja]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Sitbon]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ultrasound guided transversus abdominis plane block versus continuous wound infusion for post-caesarean analgesia: A randomized trial]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year></year>
<volume>9</volume>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arroyo-Fernández]]></surname>
<given-names><![CDATA[F.J.]]></given-names>
</name>
<name>
<surname><![CDATA[Calderón Seoane]]></surname>
<given-names><![CDATA[J.E.]]></given-names>
</name>
<name>
<surname><![CDATA[Torres Morera]]></surname>
<given-names><![CDATA[L.M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estrategias de tratamiento analgésico tras cesárea. Estado actual y nuevas alternativas]]></article-title>
<source><![CDATA[Revista Española de Anestesiología y Reanimación]]></source>
<year></year>
<volume>67</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chou]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gordon]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
<name>
<surname><![CDATA[de Leon-Casasola]]></surname>
<given-names><![CDATA[OA]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenberg]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Bickler]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Brennan]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="">
<collab>Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration</collab>
<source><![CDATA[An Updated Report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brizuela]]></surname>
<given-names><![CDATA[Yasel Gonzalez]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Katia Velázquez]]></given-names>
</name>
<name>
<surname><![CDATA[Barbeito]]></surname>
<given-names><![CDATA[Teddy Osmin Tamargo]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eficacia analgésica y seguridad de dosis única de morfina intratecal Eficacia analgésica y seguridad de dosis única de morfina intratecal]]></article-title>
<source><![CDATA[Revista Cubana de Anestesiología y Reanimación]]></source>
<year></year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>175</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kato]]></surname>
<given-names><![CDATA[Rie]]></given-names>
</name>
<name>
<surname><![CDATA[Shimamoto]]></surname>
<given-names><![CDATA[Hiroko]]></given-names>
</name>
<name>
<surname><![CDATA[Terui]]></surname>
<given-names><![CDATA[Katsuo]]></given-names>
</name>
<name>
<surname><![CDATA[yokota]]></surname>
<given-names><![CDATA[Kazumi]]></given-names>
</name>
<name>
<surname><![CDATA[Miyao]]></surname>
<given-names><![CDATA[Hideki]]></given-names>
</name>
</person-group>
<source><![CDATA[Delayed respiratory depression associated with 0.15 mg intrathecal morphine for cesarean section: a review of 1915 cases]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martín]]></surname>
<given-names><![CDATA[Sergio Cerda San]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Morfina intratecal en analgesia poscesárea]]></article-title>
<source><![CDATA[Revista Chilena de Anestesiología]]></source>
<year></year>
<volume>51</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>716-24</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Huayanay Bernabé]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno Gonzales]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Vásquez Yeng]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Gilmalca Palacios]]></surname>
<given-names><![CDATA[NV]]></given-names>
</name>
<name>
<surname><![CDATA[Arenas Velasquez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Segura Pinedo]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo del dolor postoperatorio de cesárea: Estudio observacional en el Instituto Nacional Materno Perinatal 2021]]></article-title>
<source><![CDATA[Rev Peru Investig Matern Perinat]]></source>
<year></year>
<volume>11</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>21-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Block]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rowlingson]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cowan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cowan Jr]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Efficacy of postoperative epidural analgesia: A meta-analysis]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Joshi]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnet]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Camu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fischer]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Vázquez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia del dolor posoperatorio. Repercusiones fisiopatológicas]]></article-title>
<source><![CDATA[Rev Soc Esp Dolor]]></source>
<year></year>
<numero>7</numero>
<issue>7</issue>
<page-range>465-76</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meylan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Elia]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Lysakowski]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Tramer]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials]]></article-title>
<source><![CDATA[Br J Anaesth]]></source>
<year></year>
<volume>102</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>156-67</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pöpping]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Elia]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Marret]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Wenka]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tramèr]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: A meta-analysis of randomized trials]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uchiyama]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Nakano]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Ueyama]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
<name>
<surname><![CDATA[Nishimura]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Tashiro]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Low dose intrathecal morphine and pain relief following caesarean section]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nortcliffe]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<name>
<surname><![CDATA[Buggy]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevention of postoperative nausea and vomiting after spinal morphine for Caesarean section: comparison of cyclizine, dexamethasone and placebo]]></article-title>
<source><![CDATA[British journal of anaesthesia]]></source>
<year>2003</year>
<volume>90</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>665-70</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caranza]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Jeyapalan]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
<name>
<surname><![CDATA[Buggy]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Central neuraxial opioid analgesia after caesarean section: comparison of epidural diamorphine and intrathecal morphine]]></article-title>
<source><![CDATA[International journal of obstetric anesthesia]]></source>
<year>1999</year>
<volume>8</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>90-3</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
