<?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>1726-8958</journal-id>
<journal-title><![CDATA[Revista Médica La Paz]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. La Paz]]></abbrev-journal-title>
<issn>1726-8958</issn>
<publisher>
<publisher-name><![CDATA[Colegio Médico de La Paz]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1726-89582024000200009</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[DEXMEDETOMIDINA EN BLOQUEO TAP COMO ESTRATEGIA DE ANALGESIA MULTIMODAL POSOPERATORIA EN HISTERECTOMÍA ABDOMINAL]]></article-title>
<article-title xml:lang="en"><![CDATA[DEXMEDETOMIDINE IN TAP BLOCK AS A POSTOPERATIVE MULTIMODAL ANALGESIA STRATEGY IN ABDOMINAL HYSTERECTOMY]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Trigoso]]></surname>
<given-names><![CDATA[Daisy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manzaneda Calderón]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Onishi Sadud]]></surname>
<given-names><![CDATA[Osman]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arismendi Argandoña]]></surname>
<given-names><![CDATA[Sebastián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Apaza Mamani]]></surname>
<given-names><![CDATA[Jimena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital del Norte Anestesiología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital de la Mujer Anestesiólogo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,CNS HIES Luis Uría de la Oliva Anestesiólogo]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital del Norte Anestesiólogo ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>30</volume>
<numero>2</numero>
<fpage>9</fpage>
<lpage>14</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1726-89582024000200009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1726-89582024000200009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1726-89582024000200009&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo. Demostrar la utilidad de la dexmedetomidina como coadyuvante a los anestésicos locales en el bloqueo TAP para analgesia postoperatoria en histerectomía abdominal.  Métodos. Ensayo clínico no aleatorizado a doble ciego que incluyó 108 mujeres ASA I a II sometidas a histerectomía abdominal electiva o urgente, las cuales fueron asignadas en dos grupos: grupo TAP-DEX (n=54) a las que se realizó un bloqueo TAP ecoguiado bilateral con bupivacaína 0.25% 20 mL y dexmedetomidina 1 ug/Kg y, grupo TAP-BUP (n=54) a las que se realizó un bloqueo TAP ecoguiado bilateral con bupivacaína 0.25% 20 mL. Como analgesia posoperatoria ambos grupos recibieron metamizol 2 g IV cada 8 horas y como analgesia de rescate tramadol 1 mg/Kg. Las variables medidas y comparadas fueron: edad, talla, peso, ASA, tiempo quirúrgico, dolor posoperatorio y analgesia de rescate (dosis, tiempo de inicio y consumo global).  Resultados: No se encontraron diferencias en las variables demográficas, estado físico ASA y tiempo quirúrgico. No refirieron dolor el 62.96% y el 38.89% de pacientes del grupo TAP-DEX y TAP-BUP respectivamente. No hubo diferencias en la frecuencia de dolor leve entre grupos (p=0.500). Se observó menor frecuencia de dolor moderado e intenso en el grupo TAP-DEX (9.26% y 1.85%) que en el grupo TAP-BUP (24.07% y 9.26%). El puntaje EVA, evaluado a las 2, 4, 6, 12 y 24 horas posopeartorias, fue menor en el grupo TAP-DEX (0, 0.3±0.67, 0.6±0.70, 1.2±1.23 y 1.1±1.10) que en el grupo TAP-BUP (0, 0.8±1.14, 3.1±2.64, 2.78±1.70 y 2.1±1.52). La mediana de tiempo transcurrido hasta la primera analgesia de rescate fue de 485 minutos en el grupo TAP-DEX y 280 minutos en el grupo TAP-BUP (p=0.027). No hubo diferencias (p=0.324) en la dosis de tramadol entre ambos grupos pero si se encontró diferencias (p=0.042) en el consumo global de tramadol.  Conclusiones: La adición de dexmedetomidina al anestésico local en el bloqueo TAP tiene beneficios potenciales para mejorar la calidad de analgesia posoperatoria en histerectomías abdominales.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective. To demonstrate the usefulness of dexmedetomidine as an adjuvant to local anesthetics in the TAP block for postoperative analgesia in abdominal hysterectomy.  Methods. Non-randomized double-blind clinical trial that included 108 women in ASA grade I and II undergoing elective or urgent abdominal hysterectomy, who were assigned into two groups: TAP-DEX group (n=54) who underwent a bilateral ultrasound-guided TAP block with bupivacaine 0.25% 20 mL and dexmedetomidine 1 ug/Kg, andTAP-BUP group (n=54) who underwent a bilateral ultrasound-guided TAP block with bupivacaine 0.25% 20 mL As postoperative analgesia, both groups received metamizole 2 g IV every 8 hours and tramadol 1 mg/Kg as rescue analgesia. Measured and compared variables were: age, height, weight, ASA, surgical time, postoperative pain and rescue analgesia (dose, start time and overall consumption).  Results. No differences were found concerning demographic, ASA physical status and surgical time variables. No report of pain was observed in 62.96 % of TAP-DEX group as well as 38.89% of the TAP-BUP group. There were no differences of mild pain frequency between groups (p=0.500). A lower frequency of moderate and severe pain in the TAP-DEX group (9.26% and 1.85%) than in the TAP-BUP group (24.07% and 9.26%) was observed. The VAS score, evaluated at 2, 4, 6, 12 and 24 hours postoperatively, was lower in TAP-DEX group (0, 0.3±0.67, 0.6±0.70,1.2±1.23 and 1.1±1.10) than in TAP-BUP group (0, 0.8±1.14, 3.1±2.64, 2.78±1.70 and 2.1±1.52). The median time to first rescue analgesia was 485 minutes in the TAP-DEX group and 280 minutes in the TAP-BUP group (p=0.027). There were no differences (p=0.324) in tramadol dose between both groups, but differences were found (p=0.042) in the overall consumption of tramadol.  Conclusions. The addition of dexmedetomidine to local anesthetic in the TAP block has potential benefits to improve the quality of postoperative analgesia in abdominal hysterectomies.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Bloqueo del plano transverso del abdomen]]></kwd>
<kwd lng="es"><![CDATA[dexmedetomidina]]></kwd>
<kwd lng="es"><![CDATA[dolor postoperatorio]]></kwd>
<kwd lng="es"><![CDATA[histerectomía abdominal]]></kwd>
<kwd lng="en"><![CDATA[Transversus abdominis plane block]]></kwd>
<kwd lng="en"><![CDATA[dexmedetomidine]]></kwd>
<kwd lng="en"><![CDATA[postoperative pain]]></kwd>
<kwd lng="en"><![CDATA[abdominal hysterectomy]]></kwd>
</kwd-group>
</article-meta>
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