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Comparative study of the topical treatment with Etofenamato combined with Iontoforesis versus Fonoforesis, for handling the post surgery pain.
Estudio Comparativo de Tratamiento tpico con Etofenamato, combinado con Iontoforesis versus Fonoforesis, en el manejo del dolor postoperatorio. Yadira Del Valle Franco Espinoza, Arcngel Lpez Mata, Antonio Franco Espinoza.
INTRODUCTION:
The pain is a disease itself, the IASP Taxonomy Committee (1979-1994) defines it as ...." important to study the effectiveness of different physical media techniques which combined with drugs, enhances its penetration . This is the case of Iontophoresis and Phonophoresis,
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unpleasant sensory and emotional experience related to an existing or potential tissue damage described in terms of the injury ". It is regarded as the fifth vital sign by the Accreditation Committee of the Organization of Health Care
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where drugs of topical application are used. This combination effectiveness management allow of the of us to to increase use in the the pain.
drug
It is the duty of the physician and a patient's right to be treated his pain quickly and effectively. Most acute pain and the mediate or immediate postoperative pain are of somatic origin and therefore are easy to handle, if treated early and properly. If the pain persists, it evolves into a chronic or neuropathic pain of more complexity. Which means the use of the lasts steps of the therapeutic ladder.
3,4
postoperative
When choosing a drug for the management of inflammation and resulting pain after surgery is necessary to consider the following features: good level of skin penetration, adequate
concentration in the inflamed tissue, powerful anti-inflammatory and analgesic effect, well systemic and skin tolerance, adequate profile risk benefit.
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The postoperative patient who has constant pain of increasing intensity, has limited functions of the region or regions of the body involved, and implies the associated This interferes
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For the present study Etofenamate was chosen Different experimental research studies have been developped and they demosntrates the effectiveness of Etofenamate and also that it meets the requirements we mentioned before.
11, 12, 13,14 10,
consequences.
treatment of rehabilitacin.
Therefore, it is
17 (
N1 figure).
(N 2 y N 3 Figure).
Etofenamato at 10% (application of 7cm of gel in linear form) with the technique of Sonoforesis with 1 w/cm2, direct current during 10 minutes.
Phisiatric evaluation of each case is done in order to know everything about this type pain.
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it is possible to be appreciated in the N1 table and, N 1, the Graphic evolution of the intensity average of the pain. The average of improvement of the amplitude to articulate active (AMA) and of edema is expressed in the tables N 2 and 3
The cases that entered with less time of evolution post-operative showed significant improvement in the first and fifth day of treatment. There was no significant relation between the type of surgical technique and the handling of the pain.
Conclusions:
It was demonstrated that the effectiveness of topical Etofenamato at 10% in the handling of the post-operative somatic pain with both techniques of electrotherapy fluctuates between 80% and 90%
The application of Etofenamato with Iontoforesis is better in the early remission of the post-operative somatic pain and the application of topic Etofenamato with Sonoforesis is better in the remission of edema. The improvement of the articular amplitude is directly proportional to the remission of the pain and edema.
Figure Number 1
Figure Number 2
EDEMA SCALE No Edema Mild Edema Moderate Edema 2 CM REGULAR Severe Edema
0 CM VERY GOOD
1 CM GOOD
3 CM OR > BAD
Figure Number 3
AMA SCALE AMA limited in final grades 95% - 75% GOOD AMA limited in intermediate grades 70% - 50% REGULAR AMA limited in initial grades or immobilization 45% - 0% BAD
Full AMA
Table N 1
Evolution of the intensity average of the pain both enters groups study
Treatment (T)
Averages
IONTOFORESIS SONOFORESIS
6,8 7,2
5,8 6,625
2,5 3,15
1,35 1,35
4,11 4,58
Periods of observation
T. 1er T. 5to 88,25 87,25 T. 10mo 70,42 73,50
Averages
50,75 54,75
IONTOFORESIS SONOFORESIS
72,25 78,5
Treatment (T)
Periods of observation
T. 1er T. 5to 0,675 0,39 T. 10mo 1,59 1,34
Averages
2,55 2,52
IONTOFORESIS SONOFORESIS
1,55 1,09
REFERENCES
1. IASP, Management of Acute Pain: Practical Guide. 1992, Seattle: IASP Publications. 2. Merskey H. Bugduk N., Classification of chronic pain, Description of Chronic pain. Seattle WA: IASP Press;2 .;1994. 3. Jensen TS, Baron R., Translations of symptoms and signs into mechanisms in neuropathic pain 2003;102:1-8 4. Zimmermann M. Pathobiology of neuropathic pain. Eur J Pharmacol 2001; 429.23-37. 5. Jensen MP, Turner JA, Romano JM, Fisher LD: Comparative reliability add validity of chronic pain intensity measures pain 1999;83:157-62 6. Guia Practica de Electrotherapia, Barcelona, Espaa: Edicin Carin Electromedicarin,SA; 1999. Iontoforesis. Plata J. p.20-24 7. Electroterapia en Fisioterapia de Rodrguez M.. Editorial Mdica Panamericana, SA. Madrid Espaa; 2000. Capitulo Iontoforesis y Ultrasonido. 205240, 499-520. 8. Bender T et al. Etofenamate levels in human serum and synovial fluid
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following Iontophoresis. 2001 Arzneim Forsch /Drug Res 51: 489-492 9. Beneke M, Blumberger W Clinical study of the efficacy and tolerability of Traumon Gel (TVX 485-09-02) in comparison to Dolo- Arthrosenex in the treatment of inflammatory vertebral syndroms. 1985 Scientific report Study KF 404, Tropon 10. Billigmann P, Pelster B Plazebokontrollierte Doppelblindstudie von Etofenamat-Gel (Rheumon Gel) in Kombination mit Ultraphonophorese bei Sportverletzungen.1992 Praktische Traumatologie Sportmedizin 2: 72-77 11. . Miehle W. Medikamentse Therapie. In: Miehle W [Hrsg] Rheumatologie in Praxis und Klinik. Georg Thieme Verlag, 2000 Stuttgart New York , 2. Aufl, S 253336 12. Patella V, Moretti B, Martucci G, Etofenamat und Ultrashall. 1985 Gazz Med Ital Arch Sci Med 144:575-578 13. Blumberger W Clinical testing of the effectiveness and tolerance of Etofenamate cream in the treatment of epicondylitis in comparison to
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Indomethacin ointment. 1982 Scientific report Study KF 229, Tropon 14. Dreiser RL, Lopez A,Efficacy and acceptability Etofenamato gel 5% in patients with acute sprains of the ankle.1989, Scientific report No 515 p, 77 Bayer Pharma France. 15. Kottke F, Lehemann J. Krusen, Medicina Fsica Y Rehabilitacin 4ta edicin Madrid, Espaa: Panamericana; 2002. p 1204-1210 16. Rehabilitacion en Salud 2 edicin. Salinas F., Lugo L., Restrepo R. Colombia: Editorial Universidad de Antioquia. 2008 Capitulo Dolor y Problemas Dolorosos.p.185-201 17. Reville SI, Robinson JO, Rosen M, Hogg MI. The Rehability of linear analogue scale for evaluation of pain. Anesthesia 1977;36: 186-187 18. Hernandez R, Fernandez C, Batista p, Methodology of Investigation 4 edition, Mxico: Mc Graw Hill; 2006. P. 341-351
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