Importancia de la respuesta inflamatoria en el perioperatorio y su modulación farmacológica

Katia Velázquez González; Maité Cleger Cobas

Importancia de la respuesta inflamatoria en el perioperatorio y su modulación farmacológica

Katia Velázquez González, Maité Cleger Cobas

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Resumen

Introducción: Durante el proceso quirúrgico del paciente oncológico se genera una respuesta inflamatoria en ocasiones descontrolada. Ello podría modificar el resultado posoperatorio.

Objetivo: Determinar la influencia de la respuesta inflamatoria en el resultado posoperatorio y los marcadores de mayor valor, así como la influencia de los medicamentos anestésicos en su modulación farmacológica.

Métodos: Se realizó la búsqueda de la bibliografía disponible de los últimos 10 años sobre el tema, a través de Medline, Clinical Key, Pubmed y Scopus. Se emplearon de inicio los filtros para revisar metaanálisis, revisiones sistemáticas y otros estudios de revisión.

Desarrollo: En el paciente con cáncer coinciden varios factores que desencadenan una respuesta inflamatoria. Esta ocasiona incremento de complicaciones posoperatorias y de recidiva tumoral. Existen varios marcadores que predicen esta respuesta; sin embargo, el índice neutrófilo/linfocito es el más factible y se le atribuye un elevado valor pronóstico cuando se eleva por encima de 5. Los fármacos anestésicos como la lidocaína intravenosa y algunas técnicas locorregionales permiten modular la respuesta inflamatoria.

Conclusiones: Los pacientes con índice neutrófilo/linfocito por encima de 5 tienen peores resultados posoperatorios y ello puede ser modulado con lidocaína intravenosa y el empleo siempre que sea posible de técnicas ahorradoras de opioides.

Palabras clave

índice neutrófilo/linfocito; modulación farmacológica con lidocaína intravenosa

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