These pharmacological agents are extremely valuable for multimodal post-operative pain management, but they may produce severe side effects, such as respiratory depression. 1. Hajenius PJ, Mol F, Mol BWJ, Bossuyt PMM, Ankum WM, Van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000324. 2. Miller R, Eriksson L, Fleisher L. Preoperative Evaluation. En: Miller's Anesthesia, Cap. IV: Anesthesia Management, 34. 7 ed. Elsevier; 2009. p. 69-72. 3. American Society of Anesthesiologists. ASA Physical Status Classification System. 1995-2011. Disponible en: URL: http://www.asahq.org Revisado en octubre de 2011. 4. Beck-Schimmer B, Bonvini J. Bronchoaspiration: incidence, consequences and management. Eur J Anaesthesiol. 2011;28:78-84. 5. Mace S. Challenges and advances in intubation: airway evaluation and controversies with intubation. Emerg Med Clin N Am. 2008;26:977-1000. 6. Fischer B. Benefits, risks, and best practice in regional anesthesia, do we have the evidence we need? Reg Anesth Pain Med. 2010;35:545-8. 7. Gulur P, Nishimori M, Ballantyne J. Regional anaesthesia ver-sus general anaesthesia, morbidity and mortality. Best Pract Res Clin Anaesthesiol. 2006;20:249-63. 9. Hanna M, Murphy J, Kumar K, Wu C. Regional techniques and outcome: what is the evidence? Curr Opin Anaesthesiol. 2009;22:672-7. 10. Tziavrangos E, Schug S. Regional anaesthesia and perioperative outcome. Curr Opin Anaesthesiol. 2006; Mosby. 19:521-5. 13. Gehling M., Tryba M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia. 2009;64:643-51. 14. Nolana J, Soarb J, Zideman D, Biarent D, Bossaert L, Deakin C, et al. European Resuscitation Council Guidelines for Resuscitation 2010, Section 1. Executive summary. Resuscitation. 2010;81:1219-76. 15. Field J, Hazinski M, Sayre M, Chameides L, Schexnayder S, Hemphill R, et al. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122;S640-56. 16. Kern K, Sasaoka T, Higashi H, Hilwig R, Berg R, Zuercher M. Post-resuscitation myocardial microcirculatory dysfunction is ameliorated with eptifibatide. Resuscitation. 2011;82:85-9. 17. Aehlert B. Myocardial ischemia, injury, and infarction. En ACLS. Quick Review Study Guide. 2 ed. St Louis, MS: Mosby;2005. p. 285. 18. Shapiro A, Zohar E, Zaslansky R, Hoppenstein D, Shabat S, Fredman B. The frequency and timing of respiratory depression in 1524 postoperative patients treated with systemic or neuraxial morphine. J Clin Anesth. 2005;17:537-42.
Estos agentes farmacológicos poseen inmenso valor en el manejo multimodal del dolor postoperatorio; sin embargo, no están exentos de producir efectos colaterales severos como la depresión respiratoria.