<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1134-8046</journal-id>
<journal-title><![CDATA[Revista de la Sociedad Española del Dolor]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Soc. Esp. Dolor]]></abbrev-journal-title>
<issn>1134-8046</issn>
<publisher>
<publisher-name><![CDATA[Inspira Network Group, S.L ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1134-80462018000200070</article-id>
<article-id pub-id-type="doi">10.20986/resed.2017.3593/2017</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo farmacológico del dolor agudo postoperatorio en España. Datos de la encuesta nacional de la Sociedad Española del Dolor (SED)]]></article-title>
<article-title xml:lang="en"><![CDATA[Pharmacological management of acute postoperative pain in Spain. Data from the national survey from the Spanish Pain Society (SED) (iasp chapter)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar]]></surname>
<given-names><![CDATA[J.L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montes]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benito]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caba]]></surname>
<given-names><![CDATA[F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Margarit]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Son Llatzer  ]]></institution>
<addr-line><![CDATA[Palma de Mallorca ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Parc de Salut Mar Servicio Anestesiología, Reanimación y Unidad del Dolor ]]></institution>
<addr-line><![CDATA[Barcelona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General Universitario Gregorio Marañón Servicio Anestesiología, Reanimación y Unidad del Dolor ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario de Valme Servicio de Anestesiología, Reanimación y Unidad del Dolor ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital General Universitario Servicio Anestesiología, Reanimación y Unidad del Dolor ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<volume>25</volume>
<numero>2</numero>
<fpage>70</fpage>
<lpage>85</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1134-80462018000200070&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1134-80462018000200070&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1134-80462018000200070&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La Sociedad Española del Dolor (SED), y concretamente el Grupo de Trabajo de Dolor Agudo de la misma (GTDASED), llevó a cabo una encuesta a nivel nacional para conocer la situación del manejo del dolor postoperatorio en España así como las distintas pautas analgésicas empleadas. En este artículo se analizan estas pautas y se comparan atendiendo a la presencia o no de Unidad de Dolor Agudo (UDA) o Programas de Gestión del Dolor Postoperatorio (PGDPO) entre aquellos hospitales de más de 200 camas que participaron en la misma.  Pacientes y métodos:  Los miembros de la Sociedad Española del Dolor y todos los responsables del tratamiento del dolor postoperatorio de los hospitales españoles fueron invitados a contestar un cuestionario estructurado. Para el análisis los hospitales se dividieron en 2 grupos: &lt; 200 camas y &#8805; 200 camas. Las variables categóricas fueron descritas como porcentajes con el 95 % de intervalo de confianza y las continuas con la mediana y el rango intercuartil. Se analizaron las pautas farmacológicas empleadas, sus asociaciones así como las vías de administración.  Resultados:  En total las respuestas implicaron a 112 (78 con &gt; 200 camas y 34 con &lt; 200 camas) hospitales del Sistema Nacional de Salud Español. Se obtuvieron respuestas del 42,4 % de hospitales con &#8805; 200 camas, y del 9,6 % de los de &lt; 200 camas, por lo que solo se analizó el primer grupo en lo que respecta a pautas de administración de analgesia, mientras que en el caso aislado de los fármacos empleados se analizaron los 112 hospitales que respondieron la encuesta. Las pautas orales se emplean en el 60,3 % de los hospitales (sin diferencias entre aquellos con y sin UDA), las intramusculares (i.m.) en un 15,8 %, subcutáneas (s.c.) 48,3 %, intravenosas (i.v) en bolos 75,9 %, intravenosas continuas 77,6 %, intravenosas PCA 60,3 %, catéteres en plexo nervioso a bolos 51,7 %, catéteres en plexo nervioso e infusión continua 56,9 %, epidurales en bolos 40,4 %, epidurales continuas 75,9 %, epidurales en PCA 43,1 %, (63,8 % anestésico local y opioide y 15,8 % anestésico local con otros fármacos [adrenalina/clonidina/opioide]). Solo hubo diferencia estadísticamente significativa en función de la presencia o no de UDA en el centro, en las pautas: intravenosas en PCA, catéteres en plexo nervioso con infusión continua y epidural en PCA (más empleadas en los hospitales con UDA) e intramusculares (menos empleadas en los hospitales con UDA). De los centros con &gt; 200 camas un 81,3 % utilizaron AINE en sus prescripciones orales (ibuprofeno 38,1 % y dexketoprofeno 28,6 %); un 68,8 % utilizó paracetamol (asociado a AINE en un 22 %) y un 28,1 % empleó opioides orales (tramadol en el 21,9 %). Las pautas intramusculares fueron utilizadas por un 15,8 % de los encuestados. En 55 centros (de los 112 encuestados independientemente del número de camas hospitalarias) aún se utilizan pautas subcutáneas para tratar el dolor agudo postoperatorio y de ellos el 58,3% emplea cloruro mórfico. La protocolización de co-adyuvantes es del 2,3 %. El AINE más empleado es el dexketoprofeno por vía intravenosa y el ibuprofeno por vía oral. El opioide débil más empleado es el tramadol tanto por vía oral como intravenosa. La morfina es el opioide potente más empleado, especialmente en PCA intravenosa (i.v.). El paracetamol se emplea en el 54,7 % (112 hospitales) de las pautas i.v. a bolos. El concepto de analgesia multimodal, aunque es conocido, no se práctica de modo mayoritario entre los encuestados (solo un 30 % de los centros que respondieron la encuesta lo hacen).  Conclusión:  El paracetamol y los AINE se emplean tanto por vía oral (67,4 y 86,1 %, respectivamente) como intravenosa (54,7 y 56,6 %, respectivamente). Cuando los hospitales de &gt; 200 camas disponen de UDA o PGDPO utilizan significativamente más las pautas: intravenosas en PCA, catéteres en plexo nervioso e infusión continua y epidural en PCA y menos las pautas i.m. La aplicación de analgesia multimodal es baja.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The Spanish Pain Society SED-IASP launched a national survey in order to determine how was postop pain managed throughout Spain. This article analyses the drugs and routes employed comparing them according to the presence or not of an Acute Pain Unit (APU) or Acute Pain Management program (APMP) in hospitals with &gt; 200 beds that participated and answered the survey.  Patients and methods:  Members of the Spanish Pain Society and APS/APMP heads were asked to respond to a survey. Responses were stratified by hospital size (&lt; 200 or &#8805; 200 beds) and APS/APMP presence or not. Categorical variables were described by percentages and the 95 % confidence interval and continuous ones by the median and interquartile range. The drugs employed, associations of them and routes of administration were also analysed.  Results:  A total of 112/537 hospitals responded the survey (78 with &gt;200 beds and 34 &lt; 200) which represents a 20,9 % response tax). Responses were received from 42.4 % of hospitals with &#8805; 200 beds (vs. 9.6 % of the smaller ones). We fully analysed data concerning routes and ways of administration only for the larger hospitals, 57.7 % of which had an APS or APMP. Solely drugs were analysed considering all 112 hospitals. Oral route is employed in 60,3 % hospitals (no differences between those with or not APU), intramuscular (IM) in 15,8 %, subcutaneous (SC) 48,3 %, intravenous (IV) bolus 75,9 %, IV continuous 77,6 %, IV PCA 60,3 %, catheters in nerve plexus using bolus 51,7 %, catheters in nerve plexus with continuous infusion 56,9 %, epidurals with bolus 40,4 %, continuous epidurals 75,9 %, epidural PCA 43,1 %, (63,8 % local anesthetic and opioid and 15,8 % local anesthetic with adrenaline/clonidine/opioid). Statistical significant differences were found in IV PCA route, continuous infusión through catheters in nervous plexus and epidural PCA (more employed in hospitals having an APU) and IM route (significantly less employed in them). A total of 81,3 % hospitals with &gt; 200 beds used oral NSAIDs to treat postoperative pain (ibuprophen 38,1 % and dexketoprophen 28,6 %); paracetamol was employed in 68,8 % of them (associated to NSAID in 22 %) and 28,1 % employed oral opioids (tramadol 21,9 %). Coadjuvants are only employed in 2,3 % of 112 hospitals. IV dexketoprophen and oral ibuprophen were the most frequent NSAIDs employed. Tramadol is the most commonly IV and oral opioid employed. Morphine is the strong opiod more frequently used, especially in IV PCA. Paracetamol is used in 54,7 % (112 hospitals) of IV bolus way of administration. Multimodal analgesia concept although well known is not widely established among the survey responders (only 30 % apply it).  Conclusion:  Paracetamol and NSAIDs are used by IV (54,7 y 56,6 % respectively) and oral routes (67,4 y 86,1 % respectively). Hospitals with &gt; 200 beds having an APU or APMP significantly employ more IV PCA, nerve plexus catheters continuous infusion and epidural PCA and less IM route to treat postoperative pain. Multimodal analgesia is not widely used in Spanish Hospitals.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acute pain]]></kwd>
<kwd lng="en"><![CDATA[postoperative pain]]></kwd>
<kwd lng="en"><![CDATA[analgesia]]></kwd>
<kwd lng="es"><![CDATA[Dolor agudo]]></kwd>
<kwd lng="es"><![CDATA[dolor postoperatorio]]></kwd>
<kwd lng="es"><![CDATA[analgesia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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