Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata
La cirugía de cataratas es uno de los procedimientos más frecuentes en oftalmología y requiere técnicas anestésicas que garanticen inmovilidad ocular, analgesia y seguridad. Entre las opciones, el bloqueo cantal y su combinación con el abordaje inferotemporal son ampliamente utilizados, pero su efec...
- Autores:
-
Pérez Lemus, Alejandra
- Tipo de recurso:
- Fecha de publicación:
- 2025
- Institución:
- Universidad Autónoma de Bucaramanga - UNAB
- Repositorio:
- Repositorio UNAB
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unab.edu.co:20.500.12749/30103
- Acceso en línea:
- http://hdl.handle.net/20.500.12749/30103
- Palabra clave:
- Health sciences
Medicine
peribulbar block, postoperative pain, canthal block, inferotemporal block, akinesia, anesthesiology
Medicine
Anesthesiology
Medical sciences
Cataract
Anesthesia in ophthalmology
Anesthesia (Complications)
Operative surgery
Anestesiología
Ciencias médicas
Medicina
Cataratas (Oftalmología)
Anestesia en oftalmología
Anestesia (Complicaciones)
Cirugía operatoria
Ciencias de la salud
Bloqueo peribulbar
Dolor posoperatorio
Bloqueo cantal
Bloqueo inferotemporal
Akinesia
- Rights
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| dc.title.translated.spa.fl_str_mv |
Impact of the addition of inferotemporal blockade to the internal canthal technique on total ocular akinesia for cataract surgery. |
| title |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| spellingShingle |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata Health sciences Medicine peribulbar block, postoperative pain, canthal block, inferotemporal block, akinesia, anesthesiology Medicine Anesthesiology Medical sciences Cataract Anesthesia in ophthalmology Anesthesia (Complications) Operative surgery Anestesiología Ciencias médicas Medicina Cataratas (Oftalmología) Anestesia en oftalmología Anestesia (Complicaciones) Cirugía operatoria Ciencias de la salud Bloqueo peribulbar Dolor posoperatorio Bloqueo cantal Bloqueo inferotemporal Akinesia |
| title_short |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| title_full |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| title_fullStr |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| title_full_unstemmed |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| title_sort |
Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarata |
| dc.creator.fl_str_mv |
Pérez Lemus, Alejandra |
| dc.contributor.advisor.none.fl_str_mv |
Rueda Pérez, Nelson Gómez Garces, Sonia Luz |
| dc.contributor.author.none.fl_str_mv |
Pérez Lemus, Alejandra |
| dc.contributor.cvlac.spa.fl_str_mv |
Gómez Garces, Sonia Luz [0001659600] Rueda Pérez, Nelson [0002115268] |
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Gómez Garces, Sonia Luz [es&oi=ao] |
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Gómez Garces, Sonia Luz [0000-0003-1865-2923] |
| dc.contributor.apolounab.spa.fl_str_mv |
Gómez Garces, Sonia Luz [sonia-luz-gomez-garces] |
| dc.subject.keywords.spa.fl_str_mv |
Health sciences Medicine peribulbar block, postoperative pain, canthal block, inferotemporal block, akinesia, anesthesiology Medicine Anesthesiology Medical sciences Cataract Anesthesia in ophthalmology Anesthesia (Complications) Operative surgery |
| topic |
Health sciences Medicine peribulbar block, postoperative pain, canthal block, inferotemporal block, akinesia, anesthesiology Medicine Anesthesiology Medical sciences Cataract Anesthesia in ophthalmology Anesthesia (Complications) Operative surgery Anestesiología Ciencias médicas Medicina Cataratas (Oftalmología) Anestesia en oftalmología Anestesia (Complicaciones) Cirugía operatoria Ciencias de la salud Bloqueo peribulbar Dolor posoperatorio Bloqueo cantal Bloqueo inferotemporal Akinesia |
| dc.subject.lemb.spa.fl_str_mv |
Anestesiología Ciencias médicas Medicina Cataratas (Oftalmología) Anestesia en oftalmología Anestesia (Complicaciones) Cirugía operatoria |
| dc.subject.proposal.spa.fl_str_mv |
Ciencias de la salud Bloqueo peribulbar Dolor posoperatorio Bloqueo cantal Bloqueo inferotemporal Akinesia |
| description |
La cirugía de cataratas es uno de los procedimientos más frecuentes en oftalmología y requiere técnicas anestésicas que garanticen inmovilidad ocular, analgesia y seguridad. Entre las opciones, el bloqueo cantal y su combinación con el abordaje inferotemporal son ampliamente utilizados, pero su efectividad comparativa sigue siendo debatida. El objetivo de este estudio fue comparar ambas técnicas en términos de akinesia ocular, dolor postoperatorio y presencia de complicaciones. Metodología: Cohorte prospectiva analítica en pacientes mayores de 18 años con diagnóstico de catarata. Se compararon dos técnicas anestésicas peribulbares: bloqueo peribulbar cantal aislado versus combinado con abordaje inferotemporal. La variable principal fue akinesia ocular total (escala de Brahma) y como secundaria, dolor postoperatorio (escala NRS). Se aplicó análisis descriptivo, pruebas no paramétricas y regresión logística binaria para identificar asociaciones significativas, con nivel de significancia de p < 0,05. Resultados : Un total de 114 pacientes, el bloqueo combinado presentó mayor incidencia de akinesia total (96,49% vs. 59,65%; p=0,002), menor intensidad de dolor postoperatorio a las 2 y 12 horas (p=0,0003 y p=0,0345, respectivamente) y menor tasa de complicaciones (5,3% vs. 14%). El modelo multivariado confirmó que el bloqueo combinado se asocia significativamente con mayor probabilidad de akinesia total (OR: 15,88; IC95%: 3,47–72,68; p<0,001). Conclusión : El abordaje anestésico peribulbar combinado con técnica inferotemporal ofrece mayores beneficios clínicos frente al bloqueo cantal aislado en cirugía de catarata, destacándose como una opción segura y efectiva para este tipo de procedimiento. |
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2025 |
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2025-06-26T22:05:01Z |
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2025-06-26T22:05:01Z |
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2025-06-25 |
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info:eu-repo/semantics/masterThesis |
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Tesis |
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spa |
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Brízido M, Rodrigues PF, Almeida AC, Abegão Pinto L. Cataract surgery and IOP: a systematic review of randomised controlled trials. Graefe’s Archive for Clinical and Experimental Ophthalmology [Internet]. 2023 May 1 Bernal GB, General S. ALEJANDRO GAVIRIA URIBE Ministro de Salud y Protección Social FERNANDO RUIZ GÓMEZ Viceministro de Salud Pública y Prestación de Servicios CARMEN EUGENIA DÁVILA GUERRERO Viceministra de Protección Social. Lodhi O, Tripathy K. Anesthesia for Eye Surgery. Can Anaesth Soc J [Internet]. 2023 Aug 25 [cited 2025 Jun 1];2(1):77–80. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572131/ JJ PG, E RP. Retrobulbar Block. Complications in Anesthesia [Internet]. 2025 Jan 1 [cited 2025 Jun 1];747–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32491380/ Bora V, Sood G, Dunville LM, Kramer J. Oculocardiac Reflex. Br J Anaesth [Internet]. 2024 May 7 [cited 2025 Jun 1];55(9):921. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499832/ Gropper MA., Eriksson LI., Fleisher LA., Wiener-Kronish JP., Cohen NH., Leslie Kate. Miller, Anestesia. 2021 [cited 2025 Jun 1]; Available from: https://www.jorgeayalalibrosmedicos.com.co/producto/miller-anestesia-9-edition-michael-a-gropper-lars-i-eriksson Zaghloul Foad A, Mansour MA, Badry Ahmed M, Elgamal HR, Elmekawey Ibrahim HE, Elawamy A. Real-time ultrasound-guided retrobulbar block vs blind technique for cataract surgery (pilot study). Local Reg Anesth [Internet]. 2018 [cited 2025 Jun 1];11:123. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6287535/ Johanna Archila Tibaduiza. Descripción de técnicas anestésicas regionales peribulbares para cirugía de catarata en la Fundación Oftalmológica de Santander –Clinica Carlos Ardila Lulle en el periodo de febrero a mayo de 2015. . RepositorioUNAB. Brahma AK, Pemberton CJ, Ayeko M, Morgan LH. Single medial injection peribulbar anaesthesia using prilocaine. Anaesthesia [Internet]. 1994 [cited 2025 Jun 1];49(11):1003–5. Available from: https://pubmed.ncbi.nlm.nih.gov/7802219 Dario R, Matajira C, De Salud F, De E, Departamento M, Cirugía DE, et al. BLOQUEO PERIBULBAR POR ABORDAJE CANTAL CON PUNCION UNICA PARA CIRUGIA OFTALMOLOGICA DESCRIPCION DE LA TECNICA-SERIE DE CASOS. 2016. Antony RM, Kamath AR, Jeganathan S, Rodrigues GR. A comparison of sub-tenon block with peribulbar block in small-incision cataract surgery. Indian J Ophthalmol [Internet]. 2022 Nov 1 [cited 2025 Jun 1];70(11):3840–3. Available from: https://pubmed.ncbi.nlm.nih.gov/36308108 Hessemer V. Peribulbar anesthesia versus retrobulbar anesthesia with facial block. Techniques, local anesthetics and additives, akinesia and sensory blockade, complications. Klin Monbl Augenheilkd. 1994;204(2):75–89. Wu S, Tang KC. Advanced subconjunctival anesthesia for cataract surgery. Asia-Pacific Journal of Ophthalmology [Internet]. 2018 Sep 1 [cited 2025 Jun 1];7(5):296–300. Available from: https://pubmed.ncbi.nlm.nih.gov/30264551/ Iganga O, Fasina O, Bekibele C, Ajayi B, Ogundipe A. Comparison of peribulbar with posterior sub-tenon′s anesthesia in cataract surgery among Nigerians. Middle East Afr J Ophthalmol [Internet]. 2016 Apr 1 [cited 2025 Jun 1];23(2):195–200. Available from: https://pubmed.ncbi.nlm.nih.gov/27162452/ Mahdy RA, Ghanem MT. Comparison between single-injection inferomedial and inferotemporal peribulbar blockades before cataract surgery. Ophthalmologica [Internet]. 2012 Jan [cited 2025 Jun 1];227(2):111–4. Available from: https://pubmed.ncbi.nlm.nih.gov/21829006/ Oficial De La P, Mexicana De Anestesiología S, Haberer JP, Obstler C, Deveaux A, Zahwa A. Revista Mexicana de Anestesiología Anestesia en oftalmología. Machado IP, Vasconcelos GC, Lopes RS, Gomez RS. Ophthalmic artery resistance index after peribulbar block in the presence of epinephrine. Int Ophthalmol [Internet]. 2021 Jan 1 [cited 2025 Jun 1];41(1):203–10. Available from: https://pubmed.ncbi.nlm.nih.gov/32857309/ Nagy AA, El-Sayd SH, Ahmed AA, Rajab GZE. Optimal Dose of Dexmedetomidine Retrobulbar Anesthesia during Phacoemulsification Cataract Surgery. Anesth Essays Res [Internet]. 2017 [cited 2025 Jun 1];11(4):1046. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5735448 Abdeldayem O, Amer G, Abdulla M. Postoperative Analgesic Efficacy of Sub-Tenon’s Block with Levobupivacaine in Retinal Surgery under General Anesthesia. Anesth Essays Res [Internet]. 2019 [cited 2025 Jun 1];13(3):437. Available from: https://pubmed.ncbi.nlm.nih.gov/31602058 Wu S, Tang KC. Advanced subconjunctival anesthesia for cataract surgery. Asia-Pacific Journal of Ophthalmology [Internet]. 2018 Sep 1 [cited 2025 Jun 1];7(5):296–300. Available from: https://pubmed.ncbi.nlm.nih.gov/30264551/ Kelly DJ, Farrell SM. Physiology and role of intraocular pressure in contemporary anesthesia. Anesth Analg [Internet]. 2018 May 1 [cited 2025 Jun 1];126(5):1551–62. Available from: https://pubmed.ncbi.nlm.nih.gov/29049074 Nanji KC, Roberto SA, Morley MG, Bayes J. Preventing adverse events in cataract surgery: Recommendations from a Massachusetts expert panel. Anesth Analg [Internet]. 2018 May 1 [cited 2025 Jun 1];126(5):1537–47. Available from: https://pubmed.ncbi.nlm.nih.gov/28991115 Álvarez Horga R. Dolor en la cirugía de cataratas comparando el primer ojo con el segundo. Revisión Bibliográfica. 2015 [cited 2025 Jun 1]; Available from: https://uvadoc.uva.es/handle/10324/13586 Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine [Internet]. 2001 [cited 2025 Jun 1];8(12):1153–7. Available from: https://pubmed.ncbi.nlm.nih.gov/11733293/ Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain [Internet]. 1986 [cited 2025 Jun 1];27(1):117–26. Available from: https://pubmed.ncbi.nlm.nih.gov/3785962/ Jensen MP, Turner JA, Romano JM. Chronic pain coping measures: individual vs. composite scores. Pain [Internet]. 1992 [cited 2025 Jun 1];51(3):273–80. Available from: https://pubmed.ncbi.nlm.nih.gov/1491854/ Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain [Internet]. 1994 [cited 2025 Jun 1];56(2):217–26. Available from: https://pubmed.ncbi.nlm.nih.gov/8008411/ Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) [Internet]. 2011 Nov [cited 2025 Jun 1];63(SUPPL. 11). Available from: https://pubmed.ncbi.nlm.nih.gov/22588748/ Asensio Sánchez VM, Sánchez Bascones JJ, Martín Nalda S, Merchán L. Comparación entre la anestesia retrobulbar y la anestesia peribulbar en la cirugía de la catarata. Archivos de la Sociedad Española de Oftalmologia, ISSN 0365-6691, Vol 66, No 3 (MAR), 1994, págs 171-174 [Internet]. 1994 [cited 2025 Jun 1];66(3):171–4. Available Mahdy RA, Ghanem MT. Comparison between single-injection inferomedial and inferotemporal peribulbar blockades before cataract surgery. Ophthalmologica [Internet]. 2012 Jan [cited 2025 Jun 7];227(2):111–4. Available from: https://pubmed.ncbi.nlm.nih.gov/21829006/ Ghali AM, Hafez A. Single-injection percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction. Anesth Analg [Internet]. 2010 [cited 2025 Jun 7];110(1):245–7. Available from: https://pubmed.ncbi.nlm.nih.gov/19910620 Van Den Berg AA. A comparison of two double-injection techniques for peribulbar block analgesia: Infero-temporal plus supero-medial vs. infero-temporal plus medial-percaruncular. Acta Anaesthesiol Scand [Internet]. 2005 Nov [cited 2025 Jun 7];49(10):1483–6. Available from: https://pubmed.ncbi.nlm.nih.gov/16223394 Murphy KJ, O’Donnell B. Rebound Pain—Management Strategies for Transitional Analgesia: A Narrative Review. J Clin Med [Internet]. 2025 Feb 1 [cited 2025 Jun 7];14(3). Available from: https://pubmed.ncbi.nlm.nih.gov/39941607/ Hsu JR, Mir H, Wally MK, Seymour RB, Archer KR, Attum B, et al. Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. J Orthop Trauma [Internet]. 2019 May 1 [cited 2025 Jun 7];33(5):E158–82. Available from: https://pubmed.ncbi.nlm.nih.gov/30681429/ Liu H, Brown M, Sun L, Patel SP, Li J, Cornett EM, et al. Complications and liability related to regional and neuraxial anesthesia. Best Pract Res Clin Anaesthesiol [Internet]. 2019 Dec 1 [cited 2025 Jun 7];33(4):487–97. Available from: https://pubmed.ncbi.nlm.nih.gov/31791565 Miller KM, Oetting TA, Tweeten JP, Carter K, Lee BS, Lin SR, et al. Cataract in the Adult Eye Preferred Practice Pattern. Ophthalmology [Internet]. 2022 Jan 1 [cited 2025 Jun 7];129(1):P1–126. Available from: https://pubmed.ncbi.nlm.nih.gov/34780842/ |
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Facultad Ciencias de la Salud |
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Especialización en Anestesiología |
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Rueda Pérez, Nelson49ef065b-964d-46ab-8bda-dcaf00178a0dGómez Garces, Sonia Luz370b4862-79f1-4e21-8855-7134276d34d3Pérez Lemus, Alejandra3d28d798-0adc-461f-a9b3-fc769b4f54e0Gómez Garces, Sonia Luz [0001659600]Rueda Pérez, Nelson [0002115268]Gómez Garces, Sonia Luz [es&oi=ao]Gómez Garces, Sonia Luz [0000-0003-1865-2923]Gómez Garces, Sonia Luz [sonia-luz-gomez-garces]Floridablanca (Santander, Colombia)UNAB Campus Bucaramanga2025-06-26T22:05:01Z2025-06-26T22:05:01Z2025-06-25http://hdl.handle.net/20.500.12749/30103instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coLa cirugía de cataratas es uno de los procedimientos más frecuentes en oftalmología y requiere técnicas anestésicas que garanticen inmovilidad ocular, analgesia y seguridad. Entre las opciones, el bloqueo cantal y su combinación con el abordaje inferotemporal son ampliamente utilizados, pero su efectividad comparativa sigue siendo debatida. El objetivo de este estudio fue comparar ambas técnicas en términos de akinesia ocular, dolor postoperatorio y presencia de complicaciones. Metodología: Cohorte prospectiva analítica en pacientes mayores de 18 años con diagnóstico de catarata. Se compararon dos técnicas anestésicas peribulbares: bloqueo peribulbar cantal aislado versus combinado con abordaje inferotemporal. La variable principal fue akinesia ocular total (escala de Brahma) y como secundaria, dolor postoperatorio (escala NRS). Se aplicó análisis descriptivo, pruebas no paramétricas y regresión logística binaria para identificar asociaciones significativas, con nivel de significancia de p < 0,05. Resultados : Un total de 114 pacientes, el bloqueo combinado presentó mayor incidencia de akinesia total (96,49% vs. 59,65%; p=0,002), menor intensidad de dolor postoperatorio a las 2 y 12 horas (p=0,0003 y p=0,0345, respectivamente) y menor tasa de complicaciones (5,3% vs. 14%). El modelo multivariado confirmó que el bloqueo combinado se asocia significativamente con mayor probabilidad de akinesia total (OR: 15,88; IC95%: 3,47–72,68; p<0,001). Conclusión : El abordaje anestésico peribulbar combinado con técnica inferotemporal ofrece mayores beneficios clínicos frente al bloqueo cantal aislado en cirugía de catarata, destacándose como una opción segura y efectiva para este tipo de procedimiento.1. Justificación 2. Pregunta de investigación 3. Hipótesis 4. Estado del arte 5. Marco Teórico 6. Objetivos 6.1 Objetivo general 6.2 Objetivos específicos 7. Metodología 7.1 Diseño 7.2 Área de estudio 7.3 Población de estudio o elegible 7.4 Criterios de selección 7.5 Selección de los participantes del estudio 7.6 Tamaño de la muestra 7.7 Fuente de información 7.8 Definición de variables 7.9 Formato de recolección 7.10 Procesamiento/control de calidad 7.11. Plan de análisis estadístico 7.12 Consideraciones éticas 8.Resultados 9.Discusión 10.Conclusiones Bibliografía Cronograma Presupuesto AnexosEspecializaciónCataract surgery is one of the most frequent procedures in ophthalmology and requires anesthetic techniques that guarantee ocular immobility, analgesia, and safety. Among the options, the canthal block and its combination with the inferotemporal approach are widely used, but their comparative effectiveness is still debated. This study aimed to compare both techniques in terms of ocular akinesia, postoperative pain, and the presence of complications. Methodology: Prospective analytical cohort study in patients over 18 years of age with a diagnosis of cataract. Two peribulbar anesthetic techniques were compared: isolated peribulbar canthal block versus combined with the inferotemporal approach. The main variable was total ocular akinesia (Brahma scale), and as a secondary variable, postoperative pain (NRS scale). Descriptive analysis, nonparametric tests, and binary logistic regression were applied to identify significant associations, with a significance level of p < 0.05. Results : A total of 114 patients, the combined block presented a higher incidence of total akinesia (96.49% vs. 59.65%; p = 0.002), lower postoperative pain intensity at 2 and 12 hours (p = 0.0003 and p = 0.0345, respectively), and a lower complication rate (5.3% vs. 14%). A multivariate model confirmed that the combined block is significantly associated with a higher probability of total akinesia (OR: 15.88; 95% CI: 3.47-72.68; p < 0.001). Conclusion: The peribulbar anesthetic approach combined with the inferotemporal technique offers greater clinical benefits compared to isolated canthal block in cataract surgery, standing out as a safe and effective option for this type of procedure.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Impacto de la adición del bloqueo inferotemporal a la técnica cantal interna en la akinesia ocular total para cirugía de catarataImpact of the addition of inferotemporal blockade to the internal canthal technique on total ocular akinesia for cataract surgery.Especialista en AnestesiologíaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en AnestesiologíaEANE-1049info:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMHealth sciencesMedicineperibulbar block, postoperative pain, canthal block, inferotemporal block, akinesia, anesthesiologyMedicineAnesthesiologyMedical sciencesCataractAnesthesia in ophthalmologyAnesthesia (Complications)Operative surgeryAnestesiologíaCiencias médicasMedicinaCataratas (Oftalmología)Anestesia en oftalmologíaAnestesia (Complicaciones)Cirugía operatoriaCiencias de la saludBloqueo peribulbarDolor posoperatorioBloqueo cantalBloqueo inferotemporalAkinesiaBrízido M, Rodrigues PF, Almeida AC, Abegão Pinto L. Cataract surgery and IOP: a systematic review of randomised controlled trials. Graefe’s Archive for Clinical and Experimental Ophthalmology [Internet]. 2023 May 1Bernal GB, General S. ALEJANDRO GAVIRIA URIBE Ministro de Salud y Protección Social FERNANDO RUIZ GÓMEZ Viceministro de Salud Pública y Prestación de Servicios CARMEN EUGENIA DÁVILA GUERRERO Viceministra de Protección Social.Lodhi O, Tripathy K. Anesthesia for Eye Surgery. Can Anaesth Soc J [Internet]. 2023 Aug 25 [cited 2025 Jun 1];2(1):77–80. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572131/JJ PG, E RP. Retrobulbar Block. Complications in Anesthesia [Internet]. 2025 Jan 1 [cited 2025 Jun 1];747–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32491380/Bora V, Sood G, Dunville LM, Kramer J. Oculocardiac Reflex. Br J Anaesth [Internet]. 2024 May 7 [cited 2025 Jun 1];55(9):921. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499832/Gropper MA., Eriksson LI., Fleisher LA., Wiener-Kronish JP., Cohen NH., Leslie Kate. Miller, Anestesia. 2021 [cited 2025 Jun 1]; Available from: https://www.jorgeayalalibrosmedicos.com.co/producto/miller-anestesia-9-edition-michael-a-gropper-lars-i-erikssonZaghloul Foad A, Mansour MA, Badry Ahmed M, Elgamal HR, Elmekawey Ibrahim HE, Elawamy A. Real-time ultrasound-guided retrobulbar block vs blind technique for cataract surgery (pilot study). Local Reg Anesth [Internet]. 2018 [cited 2025 Jun 1];11:123. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6287535/Johanna Archila Tibaduiza. Descripción de técnicas anestésicas regionales peribulbares para cirugía de catarata en la Fundación Oftalmológica de Santander –Clinica Carlos Ardila Lulle en el periodo de febrero a mayo de 2015. . RepositorioUNAB.Brahma AK, Pemberton CJ, Ayeko M, Morgan LH. Single medial injection peribulbar anaesthesia using prilocaine. Anaesthesia [Internet]. 1994 [cited 2025 Jun 1];49(11):1003–5. Available from: https://pubmed.ncbi.nlm.nih.gov/7802219Dario R, Matajira C, De Salud F, De E, Departamento M, Cirugía DE, et al. BLOQUEO PERIBULBAR POR ABORDAJE CANTAL CON PUNCION UNICA PARA CIRUGIA OFTALMOLOGICA DESCRIPCION DE LA TECNICA-SERIE DE CASOS. 2016.Antony RM, Kamath AR, Jeganathan S, Rodrigues GR. A comparison of sub-tenon block with peribulbar block in small-incision cataract surgery. Indian J Ophthalmol [Internet]. 2022 Nov 1 [cited 2025 Jun 1];70(11):3840–3. Available from: https://pubmed.ncbi.nlm.nih.gov/36308108Hessemer V. Peribulbar anesthesia versus retrobulbar anesthesia with facial block. Techniques, local anesthetics and additives, akinesia and sensory blockade, complications. Klin Monbl Augenheilkd. 1994;204(2):75–89.Wu S, Tang KC. Advanced subconjunctival anesthesia for cataract surgery. Asia-Pacific Journal of Ophthalmology [Internet]. 2018 Sep 1 [cited 2025 Jun 1];7(5):296–300. Available from: https://pubmed.ncbi.nlm.nih.gov/30264551/Iganga O, Fasina O, Bekibele C, Ajayi B, Ogundipe A. Comparison of peribulbar with posterior sub-tenon′s anesthesia in cataract surgery among Nigerians. Middle East Afr J Ophthalmol [Internet]. 2016 Apr 1 [cited 2025 Jun 1];23(2):195–200. Available from: https://pubmed.ncbi.nlm.nih.gov/27162452/Mahdy RA, Ghanem MT. Comparison between single-injection inferomedial and inferotemporal peribulbar blockades before cataract surgery. Ophthalmologica [Internet]. 2012 Jan [cited 2025 Jun 1];227(2):111–4. Available from: https://pubmed.ncbi.nlm.nih.gov/21829006/Oficial De La P, Mexicana De Anestesiología S, Haberer JP, Obstler C, Deveaux A, Zahwa A. Revista Mexicana de Anestesiología Anestesia en oftalmología.Machado IP, Vasconcelos GC, Lopes RS, Gomez RS. Ophthalmic artery resistance index after peribulbar block in the presence of epinephrine. Int Ophthalmol [Internet]. 2021 Jan 1 [cited 2025 Jun 1];41(1):203–10. Available from: https://pubmed.ncbi.nlm.nih.gov/32857309/Nagy AA, El-Sayd SH, Ahmed AA, Rajab GZE. Optimal Dose of Dexmedetomidine Retrobulbar Anesthesia during Phacoemulsification Cataract Surgery. Anesth Essays Res [Internet]. 2017 [cited 2025 Jun 1];11(4):1046. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5735448Abdeldayem O, Amer G, Abdulla M. Postoperative Analgesic Efficacy of Sub-Tenon’s Block with Levobupivacaine in Retinal Surgery under General Anesthesia. Anesth Essays Res [Internet]. 2019 [cited 2025 Jun 1];13(3):437. Available from: https://pubmed.ncbi.nlm.nih.gov/31602058Wu S, Tang KC. Advanced subconjunctival anesthesia for cataract surgery. Asia-Pacific Journal of Ophthalmology [Internet]. 2018 Sep 1 [cited 2025 Jun 1];7(5):296–300. Available from: https://pubmed.ncbi.nlm.nih.gov/30264551/Kelly DJ, Farrell SM. Physiology and role of intraocular pressure in contemporary anesthesia. Anesth Analg [Internet]. 2018 May 1 [cited 2025 Jun 1];126(5):1551–62. Available from: https://pubmed.ncbi.nlm.nih.gov/29049074Nanji KC, Roberto SA, Morley MG, Bayes J. Preventing adverse events in cataract surgery: Recommendations from a Massachusetts expert panel. Anesth Analg [Internet]. 2018 May 1 [cited 2025 Jun 1];126(5):1537–47. Available from: https://pubmed.ncbi.nlm.nih.gov/28991115Álvarez Horga R. Dolor en la cirugía de cataratas comparando el primer ojo con el segundo. Revisión Bibliográfica. 2015 [cited 2025 Jun 1]; Available from: https://uvadoc.uva.es/handle/10324/13586Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine [Internet]. 2001 [cited 2025 Jun 1];8(12):1153–7. Available from: https://pubmed.ncbi.nlm.nih.gov/11733293/Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain [Internet]. 1986 [cited 2025 Jun 1];27(1):117–26. Available from: https://pubmed.ncbi.nlm.nih.gov/3785962/Jensen MP, Turner JA, Romano JM. Chronic pain coping measures: individual vs. composite scores. Pain [Internet]. 1992 [cited 2025 Jun 1];51(3):273–80. Available from: https://pubmed.ncbi.nlm.nih.gov/1491854/Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain [Internet]. 1994 [cited 2025 Jun 1];56(2):217–26. Available from: https://pubmed.ncbi.nlm.nih.gov/8008411/Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) [Internet]. 2011 Nov [cited 2025 Jun 1];63(SUPPL. 11). Available from: https://pubmed.ncbi.nlm.nih.gov/22588748/Asensio Sánchez VM, Sánchez Bascones JJ, Martín Nalda S, Merchán L. Comparación entre la anestesia retrobulbar y la anestesia peribulbar en la cirugía de la catarata. Archivos de la Sociedad Española de Oftalmologia, ISSN 0365-6691, Vol 66, No 3 (MAR), 1994, págs 171-174 [Internet]. 1994 [cited 2025 Jun 1];66(3):171–4. AvailableMahdy RA, Ghanem MT. Comparison between single-injection inferomedial and inferotemporal peribulbar blockades before cataract surgery. Ophthalmologica [Internet]. 2012 Jan [cited 2025 Jun 7];227(2):111–4. Available from: https://pubmed.ncbi.nlm.nih.gov/21829006/Ghali AM, Hafez A. Single-injection percutaneous peribulbar anesthesia with a short needle as an alternative to the double-injection technique for cataract extraction. Anesth Analg [Internet]. 2010 [cited 2025 Jun 7];110(1):245–7. Available from: https://pubmed.ncbi.nlm.nih.gov/19910620Van Den Berg AA. A comparison of two double-injection techniques for peribulbar block analgesia: Infero-temporal plus supero-medial vs. infero-temporal plus medial-percaruncular. Acta Anaesthesiol Scand [Internet]. 2005 Nov [cited 2025 Jun 7];49(10):1483–6. Available from: https://pubmed.ncbi.nlm.nih.gov/16223394Murphy KJ, O’Donnell B. Rebound Pain—Management Strategies for Transitional Analgesia: A Narrative Review. J Clin Med [Internet]. 2025 Feb 1 [cited 2025 Jun 7];14(3). Available from: https://pubmed.ncbi.nlm.nih.gov/39941607/Hsu JR, Mir H, Wally MK, Seymour RB, Archer KR, Attum B, et al. Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. J Orthop Trauma [Internet]. 2019 May 1 [cited 2025 Jun 7];33(5):E158–82. Available from: https://pubmed.ncbi.nlm.nih.gov/30681429/Liu H, Brown M, Sun L, Patel SP, Li J, Cornett EM, et al. Complications and liability related to regional and neuraxial anesthesia. Best Pract Res Clin Anaesthesiol [Internet]. 2019 Dec 1 [cited 2025 Jun 7];33(4):487–97. Available from: https://pubmed.ncbi.nlm.nih.gov/31791565Miller KM, Oetting TA, Tweeten JP, Carter K, Lee BS, Lin SR, et al. Cataract in the Adult Eye Preferred Practice Pattern. Ophthalmology [Internet]. 2022 Jan 1 [cited 2025 Jun 7];129(1):P1–126. Available from: https://pubmed.ncbi.nlm.nih.gov/34780842/https://apolo.unab.edu.co/en/persons/sonia-luz-gomez-garcesORIGINALCopia de Protocolo Final - V6 .pdfCopia de Protocolo Final - V6 .pdfTesisapplication/pdf16725481https://repository.unab.edu.co/bitstream/20.500.12749/30103/2/Copia%20de%20Protocolo%20Final%20-%20V6%20.pdf143a6c4f08da91993eda9535e86ea488MD52open accessLicencia.pdfLicencia.pdfLicenciaapplication/pdf218952https://repository.unab.edu.co/bitstream/20.500.12749/30103/5/Licencia.pdf8256a0eddf9dc155450225de596f59e8MD55metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/30103/4/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD54open accessTHUMBNAILCopia de Protocolo Final - V6 .pdf.jpgCopia de Protocolo Final - V6 .pdf.jpgIM Thumbnailimage/jpeg5471https://repository.unab.edu.co/bitstream/20.500.12749/30103/6/Copia%20de%20Protocolo%20Final%20-%20V6%20.pdf.jpg62ff2e8c49480ff8c201a23a44446a7dMD56open accessLicencia.pdf.jpgLicencia.pdf.jpgIM Thumbnailimage/jpeg13022https://repository.unab.edu.co/bitstream/20.500.12749/30103/7/Licencia.pdf.jpg718354ffd9c27607c79cb1fdc29197a6MD57metadata only access20.500.12749/30103oai:repository.unab.edu.co:20.500.12749/301032025-06-26 22:00:17.393open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.coRUwoTE9TKSBBVVRPUihFUyksIG1hbmlmaWVzdGEobWFuaWZlc3RhbW9zKSBxdWUgbGEgb2JyYSBvYmpldG8gZGUgbGEgcHJlc2VudGUgYXV0b3JpemFjacOzbiBlcyBvcmlnaW5hbCB5IGxhIHJlYWxpesOzIHNpbiB2aW9sYXIgbyB1c3VycGFyIGRlcmVjaG9zIGRlIGF1dG9yIGRlIHRlcmNlcm9zLCBwb3IgbG8gdGFudG8sIGxhIG9icmEgZXMgZGUgZXhjbHVzaXZhIGF1dG9yw61hIHkgdGllbmUgbGEgdGl0dWxhcmlkYWQgc29icmUgbGEgbWlzbWEuCgpFbiBjYXNvIGRlIHByZXNlbnRhcnNlIGN1YWxxdWllciByZWNsYW1hY2nDs24gbyBhY2Npw7NuIHBvciBwYXJ0ZSBkZSB1biB0ZXJjZXJvIGVuIGN1YW50byBhIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBzb2JyZSBsYSBvYnJhIGVuIGN1ZXN0acOzbi4gRWwgQVVUT1IgYXN1bWlyw6EgdG9kYSBsYSByZXNwb25zYWJpbGlkYWQsIHkgc2FsZHLDoSBlbiBkZWZlbnNhIGRlIGxvcyBkZXJlY2hvcyBhcXXDrSBhdXRvcml6YWRvcywgcGFyYSB0b2RvcyBsb3MgZWZlY3RvcyBsYSBVTkFCIGFjdMO6YSBjb21vIHVuIHRlcmNlcm8gZGUgYnVlbmEgZmUuCgpFbCBBVVRPUiBhdXRvcml6YSBhIGxhIFVuaXZlcnNpZGFkIEF1dMOzbm9tYSBkZSBCdWNhcmFtYW5nYSBwYXJhIHF1ZSBlbiBsb3MgdMOpcm1pbm9zIGVzdGFibGVjaWRvcyBlbiBsYSBMZXkgMjMgZGUgMTk4MiwgTGV5IDQ0IGRlIDE5OTMsIERlY2lzacOzbiBBbmRpbmEgMzUxIGRlIDE5OTMgeSBkZW3DoXMgbm9ybWFzIGdlbmVyYWxlcyBzb2JyZSBsYSBtYXRlcmlhLCB1dGlsaWNlIGxhIG9icmEgb2JqZXRvIGRlIGxhIHByZXNlbnRlIGF1dG9yaXphY2nDs24uCg== |