18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos?

El | SpringerLink

¿Las bolsas de hielo reducen el dolor de incisión

postoperatoria de la línea media, los AINE o el uso de
narcóticos?
Revista Mundial de Cirugía

pp 1–7 | Citar como

Bharadhwaj Ravindhran (1)

Sendhil Rajan (1) Autor de correo electrónico (sendhil1986@gmail.com)
Gayatri Balachandran (2)
L. N. Mohan (1)

1. Departamento de Cirugía General , St. John's Medical College , , Bengaluru , India

2. Departamento de Gastroenterología Quirúrgica , Sakra World Hospital , , Bengaluru , India

Cirugía en países de bajos y medianos ingresos

Primero en línea: 14 agosto 2019

1 acciones
5 descargas

Resumen

Fondo

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 1/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

La analgesia postoperatoria adecuada, especialmente después de una cirugía abdominal mayor, es importante para la
recuperación, la movilidad temprana y la satisfacción del paciente. Nuestro objetivo fue estudiar los efectos de la crioterapia
a través de una bolsa de hielo en el postoperatorio inmediato, para pacientes sometidos a operaciones abdominales mayores.

Métodos

Este estudio prospectivo se realizó en nuestro centro de referencia de atención terciaria en un país de ingresos bajos y
medianos. Las características preoperatorias del paciente, las variables intraoperatorias y los resultados postoperatorios se
compararon entre dos conjuntos de pacientes. La crioterapia se administró a través de paquetes de gel congelado durante 24
h inmediatamente después de la laparotomía. El alivio del dolor se evaluó con puntajes analógicos visuales de dolor (EVA).
Las comparaciones entre grupos se midieron mediante la prueba de Chi-cuadrado, la prueba exacta de Fischer o la prueba U
de Mann-Whitney , según corresponda.

Resultados

Sesenta y ocho pacientes fueron incluidos en el estudio: 33 en el grupo de crioterapia y 35 en el grupo sin crioterapia. Las
puntuaciones medias de dolor postoperatorio (EAV) fueron significativamente más bajas en el grupo de crioterapia frente al
grupo control (3,97 ± 0,6 frente a 4,9 ± 0,7 en el día postoperatorio (POD) 1; p <0,001 y 3 ± 0,5 frente a 09 ± 0,8 en POD2 ;
p <0,001). La mediana del uso de narcóticos en equivalentes de morfina fue menor en el grupo de crioterapia de POD 1-3
(66 (IQR-16) frente a 89 (IQR-17); p = 0.001). No se observaron diferencias significativas en el uso de AINE entre los
grupos. También se descubrió que el grupo de crioterapia tenía una menor incidencia de infección del sitio quirúrgico ( p =
0.03) y una mejor función pulmonar basada en la espirometría de incentivo ( p = 0.01) y demostró una recuperación
funcional anterior basada en su capacidad para realizar la prueba de estar sentado ( p = 0.001).

Conclusión

Las bolsas de hielo son un adyuvante simple y rentable para el tratamiento del dolor postoperatorio estándar que reduce el
dolor y el uso de narcóticos y promueve la rehabilitación temprana.

Esta es una vista previa del contenido de la suscripción, inicie sesión para verificar el acceso.

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 2/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

Notas

Nota del editor

Springer Nature se mantiene neutral con respecto a las reclamaciones jurisdiccionales en mapas publicados y afiliaciones
institucionales.

Referencias
1) Brennan TJ, Vandermeulen EP, Gebhart GF (1996) Caracterización de un modelo de rata de dolor incisional. Pain 64:
493–501
CrossRef (https://doi.org/10.1016/0304-3959(95)01441-1)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Characterization%20of%20a%20rat%20model%20of%20incisional%20pain&author=TJ.%20Brennan&author
=EP.%20Vandermeulen&author=GF.%20Gebhart&journal=Pain&volume=64&pages=493-
501&publication_year=1996)
2) Zahn PK, Pogatzki EM, Brennan TJ (2002) Mecanismos para el dolor causado por incisiones. Reg Anesthesiol Pain
Med 27: 514–516
CrossRef (https://doi.org/10.1097/00115550-200209000-00014)
Google Académico (http://scholar.google.com/scholar_lookup?
title=Mechanisms%20for%20pain%20caused%20by%20incisions&author=PK.%20Zahn&author=EM.%20Pogatzki&
author=TJ.%20Brennan&journal=Reg%20Anesthesiol%20Pain%20Med&volume=27&pages=514-
516&publication_year=2002)
3) Gerbershagen HJ, Pogatzki-Zahn E, Aduckathil S et al (2014) Análisis de factores de riesgo específicos del
procedimiento para el desarrollo de dolor postoperatorio severo. Anestesiología 120: 1237–1245
CrossRef (https://doi.org/10.1097/ALN.0000000000000108)
Google Scholar (http://scholar.google.com/scholar_lookup?title=Procedure-
specific%20risk%20factor%20analysis%20for%20the%20development%20of%20severe%20postoperative%20pain&

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 3/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

author=HJ.%20Gerbershagen&author=E.%20Pogatzki-
Zahn&author=S.%20Aduckathil&journal=Anesthesiology&volume=120&pages=1237-1245&publication_year=2014)
4) Maier C, Nestler N, Richter H (2010) La calidad del tratamiento del dolor en los hospitales alemanes. Dtsch Arztebl
Int 107: 607–614
Google Scholar (http://scholar.google.com/scholar_lookup?
title=The%20quality%20of%20pain%20management%20in%20German%20hospitals&author=C.%20Maier&author
=N.%20Nestler&author=H.%20Richter&journal=Dtsch%20Arztebl%20Int&volume=107&pages=607-
614&publication_year=2010)
5) Fletcher D, Stamer Pogatzki-Zahn UM (2015) Dolor posquirúrgico crónico en Europa: un estudio observacional. Eur
J Anaesthesiol 32: 725–734
CrossRef (https://doi.org/10.1097/EJA.0000000000000319)
Google Académico (http://scholar.google.com/scholar_lookup?
title=Chronic%20postsurgical%20pain%20in%20Europe%3A%20an%20observational%20study&author=D.%20Flet
cher&author=UM.%20Stamer%20Pogatzki-Zahn&journal=Eur%20J%20Anaesthesiol&volume=32&pages=725-
734&publication_year=2015)
6) Reuben SS (2007) Dolor crónico después de la cirugía: ¿qué podemos hacer para prevenirlo? Curr Pain Dolor de
cabeza Rep 11: 5–13
CrossRef (https://doi.org/10.1007/s11916-007-0015-9)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Chronic%20pain%20after%20surgery%3A%20what%20can%20we%20do%20to%20prevent%20it&author=SS.
%20Reuben&journal=Curr%20Pain%20Headache%20Rep&volume=11&pages=5-13&publication_year=2007)
7) Reuben SS, Eckman EF (2007) El efecto de iniciar un régimen analgésico multimodal preventivo sobre los resultados
a largo plazo del paciente para la cirugía ambulatoria de reconstrucción del ligamento cruzado anterior. Anesth Analg
105: 19–20
CrossRef (https://doi.org/10.1213/01.ane.0000265444.73604.f0)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=The%20effect%20of%20initiating%20a%20preventive%20multimodal%20analgesic%20regimen%20on%20lon
g-
term%20patient%20outcomes%20for%20outpatient%20anterior%20cruciate%20ligament%20reconstruction%20su
rgery&author=SS.%20Reuben&author=EF.%20Eckman&journal=Anesth%20Analg&volume=105&pages=19-
20&publication_year=2007)
8) Reuben SS, Buvanendran M (2007) Prevención del desarrollo de dolor crónico después de la cirugía ortopédica con
técnicas analgésicas multimodales preventivas. J Bone Joint Surg Am 89: 1343–1358

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 4/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

CrossRef (https://doi.org/10.2106/JBJS.F.00906)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Preventing%20the%20development%20of%20chronic%20pain%20after%20orthopaedic%20surgery%20with%
20preventive%20multimodal%20analgestic%20tehniques&author=SS.%20Reuben&author=M.%20Buvanendran&jo
urnal=J%20Bone%20Joint%20Surg%20Am&volume=89&pages=1343-1358&publication_year=2007)
9) Faboya A, Tíos D (2007) Manejo del dolor después del parto por cesárea: enfoque multimodal. Int J Obstet
Anesthesiol 15: 185–186
CrossRef (https://doi.org/10.1016/j.ijoa.2006.11.001)
Google Académico (http://scholar.google.com/scholar_lookup?
title=Post%20Caesarean%20delivery%20pain%20management%3A%20multimodal%20approach&author=A.%20Fa
boya&author=D.%20Uncles&journal=Int%20J%20Obstet%20Anesthesiol&volume=15&pages=185-
186&publication_year=2007)
10) Raue W, Haase O, Junghans T et al (2004) El programa de rehabilitación multimodal 'Fast-track' mejora el resultado
después de la sigmoidectomía laparoscópica: una evaluación prospectiva controlada. Surg Endosc 18: 1463–1468
CrossRef (https://doi.org/10.1007/s00464-003-9238-y)
Google Scholar (http://scholar.google.com/scholar_lookup?title=%27Fast-
track%27%20multimodal%20rehabilitation%20program%20improves%20outcome%20after%20laparoscopic%20sig
moidectomy%3A%20a%20controlled%20prospective%20evaluation&author=W.%20Raue&author=O.%20Haase&au
thor=T.%20Junghans&journal=Surg%20Endosc&volume=18&pages=1463-1468&publication_year=2004)
11) Schumacher MA, Basabaum AI (2009) Capítulo 31. Analgésicos opioides y antagonistas. En: Katsung B, Master S,
Trevor A (eds) Farmacología básica y clínica. 11ª ed. McGrawHill, San Francisco
Google Académico (https://scholar.google.com/scholar?
q=Schumacher%20MA%2C%20Basabaum%20AI%20%282009%29%20Chapter%2031.%20Opiod%20analgesics%2
0and%20antagonists.%20In%3A%20Katsung%20B%2C%20Master%20S%2C%20Trevor%20A%20%28eds%29%20
Basic%20and%20clinical%20pharmacology.%2011th%20ed.%20McGrawHill%2C%20San%20Francisco)
12) Wheeler M, Oderda G, Ashburn M (2002) Eventos adversos asociados con la analgesia postoperatoria de opiáceos;
Una revisión sistémica. J Pain 3: 159–180
CrossRef (https://doi.org/10.1054/jpai.2002.123652)
Google Académico (http://scholar.google.com/scholar_lookup?
title=Adverse%20events%20associated%20with%20postoperative%20opiod%20analgesia%3B%20a%20systemic%2
0review&author=M.%20Wheeler&author=G.%20Oderda&author=M.%20Ashburn&journal=J%20Pain&volume=3&
pages=159-180&publication_year=2002)

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 5/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

13) Nalder SF, Weingand K, Kruse RJ (2004) The physiologic basis and clinical applications of cryotherapy and
thermotherapy for the pain practitioner. Pain Phys 7:395–399
Google Scholar (http://scholar.google.com/scholar_lookup?
title=The%20physiologic%20basis%20and%20clinical%20applications%20of%20cryotherapy%20and%20thermothe
rapy%20for%20the%20pain%20practitioner&author=SF.%20Nalder&author=K.%20Weingand&author=RJ.%20Kru
se&journal=Pain%20Phys&volume=7&pages=395-399&publication_year=2004)
14. Hirvonen HE, Mikkelsson MK, Kautiainen H et al (2006) Effectiveness of different cryotherapies on pain and disease
activity in active rheumatoid arthritis. A randomized single blinded controlled trial. Clin Exp Rheumatol 24:295–301
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Effectiveness%20of%20different%20cryotherapies%20on%20pain%20and%20disease%20activity%20in%20ac
tive%20rheumatoid%20arthritis.%20A%20randomized%20single%20blinded%20controlled%20trial&author=HE.%
20Hirvonen&author=MK.%20Mikkelsson&author=H.%20Kautiainen&journal=Clin%20Exp%20Rheumatol&volume
=24&pages=295-301&publication_year=2006)
15. Bleakley C, McDonough S, MacAuley D (2004) The use of ice in the treatment of acute soft tissue injury: a systemic
review of randomized controlled trials. Am J Sports Med 2:251–261
CrossRef (https://doi.org/10.1177/0363546503260757)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=The%20use%20of%20ice%20in%20the%20treatment%20of%20acute%20soft%20tissue%20injury%3A%20a%
20systemic%20review%20of%20randomized%20controlled%20trials&author=C.%20Bleakley&author=S.%20McDo
nough&author=D.%20MacAuley&journal=Am%20J%20Sports%20Med&volume=2&pages=251-
261&publication_year=2004)
16. Koc M, Tez M, Yoldas O et al (2006) Cooling for the reduction of postoperative pain: prospective randomized study.
Hernia 10:184–186
CrossRef (https://doi.org/10.1007/s10029-005-0062-2)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Cooling%20for%20the%20reduction%20of%20postoperative%20pain%3A%20prospective%20randomized%20
study&author=M.%20Koc&author=M.%20Tez&author=O.%20Yoldas&journal=Hernia&volume=10&pages=184-
186&publication_year=2006)
17. Watkins AA, Johnson TV, Shrewsberry AB et al (2014) Ice packs reduce postoperative midline incision pain and
narcotic use: a randomized controlled trial. J Am Coll Surg 219:511–517
CrossRef (https://doi.org/10.1016/j.jamcollsurg.2014.03.057)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Ice%20packs%20reduce%20postoperative%20midline%20incision%20pain%20and%20narcotic%20use%3A%

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 6/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

20a%20randomized%20controlled%20trial&author=AA.%20Watkins&author=TV.%20Johnson&author=AB.%20Sh
rewsberry&journal=J%20Am%20Coll%20Surg&volume=219&pages=511-517&publication_year=2014)
18. Van der Westhuijzen A, Becker P, Morkel J (2005) A randomized observer blind comparison of bilateral facial ice
pack therapy with no ice pack therapy following third molar surgery. Int J Oral Maxillofac Surg 34:281–286
CrossRef (https://doi.org/10.1016/j.ijom.2004.05.006)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=A%20randomized%20observer%20blind%20comparison%20of%20bilateral%20facial%20ice%20pack%20ther
apy%20with%20no%20ice%20pack%20therapy%20following%20third%20molar%20surgery&author=A.%20Westh
uijzen&author=P.%20Becker&author=J.%20Morkel&journal=Int%20J%20Oral%20Maxillofac%20Surg&volume=34
&pages=281-286&publication_year=2005)
19. Su EP, Perna M, Boettner F et al (2012) A prospective, multi-center, randomised trial to evaluate the efficacy of a
cryopneumatic device on total knee arthroplasy recovery. J Bone Join Surg Br 94:153–156
CrossRef (https://doi.org/10.1302/0301-620X.94B11.30832)
Google Scholar (http://scholar.google.com/scholar_lookup?title=A%20prospective%2C%20multi-
center%2C%20randomised%20trial%20to%20evaluate%20the%20efficacy%20of%20a%20cryopneumatic%20device
%20on%20total%20knee%20arthroplasy%20recovery&author=EP.%20Su&author=M.%20Perna&author=F.%20Boe
ttner&journal=J%20Bone%20Join%20Surg%20Br&volume=94&pages=153-156&publication_year=2012)
20. Sarifakioglu N, Sarifakioglu E (2004) Evaluating the effects of ice application on the pain felt during botulinum toxin
type-a injections: a prospective, randomized, single-blind controlled trial. Ann Plast Surg 53:543–546
CrossRef (https://doi.org/10.1097/01.sap.0000139563.51598.75)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Evaluating%20the%20effects%20of%20ice%20application%20on%20the%20pain%20felt%20during%20botuli
num%20toxin%20type-a%20injections%3A%20a%20prospective%2C%20randomized%2C%20single-
blind%20controlled%20trial&author=N.%20Sarifakioglu&author=E.%20Sarifakioglu&journal=Ann%20Plast%20Su
rg&volume=53&pages=543-546&publication_year=2004)
21. Swenson C, Swärd L, Karlsson J (1996) Cryotherapy in sports medicine. Scand J Med Sci Sports 6:193–200
CrossRef (https://doi.org/10.1111/j.1600-0838.1996.tb00090.x)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Cryotherapy%20in%20sports%20medicine&author=C.%20Swenson&author=L.%20Sw%C3%A4rd&author=J.
%20Karlsson&journal=Scand%20J%20Med%20Sci%20Sports&volume=6&pages=193-200&publication_year=1996)
22. McDowell JH, McFarland EG, Nalli BJ (1994) Use of cryotherapy for orthopaedic patients. Orthop Nurs 13:21–30
CrossRef (https://doi.org/10.1097/00006416-199409000-00006)

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 7/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

Google Scholar (http://scholar.google.com/scholar_lookup?

title=Use%20of%20cryotherapy%20for%20orthopaedic%20patients&author=JH.%20McDowell&author=EG.%20M
cFarland&author=BJ.%20Nalli&journal=Orthop%20Nurs&volume=13&pages=21-30&publication_year=1994)
23. Walker FO, Neal JM (1990) Cooling potentiates lidocaine inhibition of median nerve sensory fibers. Anesthesia
Analgesia 70:507–511
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Cooling%20potentiates%20lidocaine%20inhibition%20of%20median%20nerve%20sensory%20fibers&author=
FO.%20Walker&author=JM.%20Neal&journal=Anesthesia%20Analgesia&volume=70&pages=507-
511&publication_year=1990)
24. Greenstein G et al (2007) Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review.
J Peridontol 78:790–800
CrossRef (https://doi.org/10.1902/jop.2007.060319)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Therapeutic%20efficacy%20of%20cold%20therapy%20after%20intraoral%20surgical%20procedures%3A%20
a%20literature%20review&author=G.%20Greenstein&journal=J%20Peridontol&volume=78&pages=790-
800&publication_year=2007)
25. Evans PJ et al (1981) Cryoanalgesia. The application of low temperatures to nerves to produce anaesthesia or
analgesia. Anaesthesia 36:1003–1013
CrossRef (https://doi.org/10.1111/j.1365-2044.1981.tb08673.x)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Cryoanalgesia.%20The%20application%20of%20low%20temperatures%20to%20nerves%20to%20produce%2
0anaesthesia%20or%20analgesia&author=PJ.%20Evans&journal=Anaesthesia&volume=36&pages=1003-
1013&publication_year=1981)
26. Adie S, Kwan A, Naylor JM (2012) Cryotherapy following total knee replacement. Cochrane Db Syst Rev 9:CD007911
Google Scholar (https://scholar.google.com/scholar?
q=Adie%20S%2C%20Kwan%20A%2C%20Naylor%20JM%20%282012%29%20Cryotherapy%20following%20total%
20knee%20replacement.%20Cochrane%20Db%20Syst%20Rev%209%3ACD007911)
27. Murgier J, Cassard X (2014) Cryotherapy with dynamic intermittent compression for analgesia after anterior cruciate
ligament reconstruction. Prelim Study Orthop Traumatol-Sur 100:309–312
CrossRef (https://doi.org/10.1016/j.otsr.2013.12.019)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Cryotherapy%20with%20dynamic%20intermittent%20compression%20for%20analgesia%20after%20anterior

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 8/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

%20cruciate%20ligament%20reconstruction&author=J.%20Murgier&author=X.%20Cassard&journal=Prelim%20St
udy%20Orthop%20Traumatol-Sur&volume=100&pages=309-312&publication_year=2014)
28. Kol E, Erdogan A, Karslı B (2013) Evaluation of the outcomes of ice application for the control of pain associated with
chest tube irritation. Pain Manag Nurs 14:29–35
CrossRef (https://doi.org/10.1016/j.pmn.2010.05.001)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Evaluation%20of%20the%20outcomes%20of%20ice%20application%20for%20the%20control%20of%20pain
%20associated%20with%20chest%20tube%20irritation&author=E.%20Kol&author=A.%20Erdogan&author=B.%20
Karsl%C4%B1&journal=Pain%20Manag%20Nurs&volume=14&pages=29-35&publication_year=2013)
29. Akan M, Misirlioglu A, Yildirim S et al (2003) Ice application to minimize pain in the split- thickness skin graft donor
site. Aesthetic Plast Surg 27:305–307
CrossRef (https://doi.org/10.1007/s00266-003-3014-1)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Ice%20application%20to%20minimize%20pain%20in%20the%20split-
%20thickness%20skin%20graft%20donor%20site&author=M.%20Akan&author=A.%20Misirlioglu&author=S.%20Y
ildirim&journal=Aesthetic%20Plast%20Surg&volume=27&pages=305-307&publication_year=2003)
30. John Hochberg M (2001) A randomized prospective study to assess the efficacy of two cold- therapy treatments
following carpal tunnel release. J Hand Ther 14:208
CrossRef (https://doi.org/10.1016/S0894-1130(01)80055-7)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=A%20randomized%20prospective%20study%20to%20assess%20the%20efficacy%20of%20two%20cold-
%20therapy%20treatments%20following%20carpal%20tunnel%20release&author=M.%20John%20Hochberg&jour
nal=J%20Hand%20Ther&volume=14&pages=208&publication_year=2001)
31. Kwekkeboom KL (2001) Pain management strategies used by patients with breast and gynecologic cancer with
postoperative pain. Cancer Nurs 24:378–386
CrossRef (https://doi.org/10.1097/00002820-200110000-00009)
Google Scholar (http://scholar.google.com/scholar_lookup?
title=Pain%20management%20strategies%20used%20by%20patients%20with%20breast%20and%20gynecologic%2
0cancer%20with%20postoperative%20pain&author=KL.%20Kwekkeboom&journal=Cancer%20Nurs&volume=24&
pages=378-386&publication_year=2001)

Copyright information

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 9/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

© Société Internationale de Chirurgie 2019

About this article

Cita este artículo como:
Ravindhran, B., Rajan, S., Balachandran, G. y col. World J Surg (2019). https://doi.org/10.1007/s00268-019-05129-1

Primero en línea el 14 de agosto de 2019

DOI https://doi.org/10.1007/s00268-019-05129-1
Nombre del editor Springer International Publishing
Imprimir ISSN 0364-2313
En línea ISSN 1432-2323

Sobre esta revista

Reimpresiones y permisos

Publicado en cooperación con

Sociedad Internacional de Cirugía

Personalised recommendations

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 10/11
18/8/2019 ¿Las bolsas de hielo reducen el dolor de incisión postoperatoria de la línea media, los AINE o el uso de narcóticos? El | SpringerLink

1. Perioperatives Management unfallchirurgischer Patienten unter Therapie mit direkten oralen Antikoagulanzien
Henze, Larissa… Junghanß, Christian
Der Unfallchirurg (2019)

2. Das postoperative Blutungsrisiko bei niereninsuffizienten Patienten — Präoperative Bewertung, Prophylaxe und Therapie
Hopt, U. T.… Bockhorn, H.
Risiko in der Chirurgie (2019)

3. Aspirin und perioperatives Blutungsrisiko

Haas, S.
Der Chirurg (2006)

Want recommendations via email? Sign up now Powered by:

© 2019 Springer Nature Switzerland AG. Parte de Springer Nature .

No conectado No afiliado 190.2.118.123

https://link.springer.com/article/10.1007%2Fs00268-019-05129-1 11/11