<?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>S1134-80462018000400207</article-id>
<article-id pub-id-type="doi">10.20986/resed.2018.3619/2017</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Efectividad analgésica de clonidina vs. morfina como coadyuvantes de la anestesia espinal con bupivacaína hiperbárica en pacientes sometidas a cesárea]]></article-title>
<article-title xml:lang="en"><![CDATA[Effectiveness of clonidine vs. morphine as coadjuvants to spinal anesthesia with hyperbaric bupivacaine in cesarean patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Montes]]></surname>
<given-names><![CDATA[J.M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lizcano-Contreras]]></surname>
<given-names><![CDATA[C.T.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Hernández]]></surname>
<given-names><![CDATA[L.F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Sánchez]]></surname>
<given-names><![CDATA[L.M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vallejo-Agudelo]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Dr. Pedro Emilio Carrillo Servicio de Anestesiología ]]></institution>
<addr-line><![CDATA[Valera ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Los Andes Hospital Universitario Dr. Pedro Emilio Carrillo Servicio de Medicina Interna]]></institution>
<addr-line><![CDATA[Valera ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Pontificia Bolivariana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Pontificia Bolivariana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Pontificia Bolivariana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<volume>25</volume>
<numero>4</numero>
<fpage>207</fpage>
<lpage>213</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1134-80462018000400207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1134-80462018000400207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1134-80462018000400207&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Los principales adyuvantes de la bupivacaína son los opioides y la clonidina; el primer opioide usado por vía epidural fue la morfina, que desde 1979 se ha demostrado el beneficio de su uso tanto por vía intratecal como extradural, para el manejo de dolor crónico y postoperatorio.  Objetivo:  Determinar la efectividad analgésica de clonidina vs. morfina como coadyuvantes de la anestesia espinal con bupivacaína hiperbárica en pacientes sometidas a cesárea.  Método:  Ensayo clínico correlacional cuasi experimental de campo. 60 pacientes con embarazo a término y feto único programadas para cesárea, con anestesia espinal, distribuidas en dos grupos. Grupo BC (n = 30): bupivacaína hiperbárica 10 mg más clonidina 75 µg; grupo BM (n = 30): bupivacaína hiperbárica 10 mg más morfina 100 µg.  Resultados:  Se evidencian diferencias estadísticamente significativas, p = 0,02, entre el tiempo de 14,5 ± 2,1 horas desde la administración de la anestesia hasta la solicitud de la primera dosis de analgesia adicional en el grupo morfina vs. clonidina con 8,18 ± 2,91 horas. El dolor en el momento de la solicitud de analgesia fue superior para clonidina con 6,4 ± 1,0 puntos de EVA con relación a la morfina con 0,93 ± 2,4 puntos, p = 0,001. Los valores de EVA también fueron significativamente mayores para clonidina con relación a la morfina a las 6, 12 y 18 horas. No se presentaron cambios hemodinámicos ni respiratorios significativos en ninguno de los dos grupos. Para la morfina el efecto adverso más frecuente fue prurito en 66,7 % de las pacientes. El nivel de sedación fue el mismo para clonidina y morfina en la totalidad de las pacientes.  Conclusiones:  Adicionar 100 &#956;g de morfina a la bupivacaína hiperbárica en anestesia espinal, prolonga y mejora significativamente el tiempo y la calidad analgésica en el periodo postquirúrgico en mayor grado que 75 &#956;g de clonidina. El efecto secundario más frecuente es el prurito.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The main adjuvants of bupivacaine are opioids and clonidine; the first opioid used by the epidural route was morphine, which since 1979 has demonstrated benefit of its intrathecal and extradural use, for the management of chronic and postoperative pain.  Objective:  Determine the analgesic effectiveness of morphine vs. clonidine added to spinal anesthesia with hyperbaric bupivacaine in patients undergoing cesarean section.  Method:  A quasi-experimental correlational clinical trial. 60 parturients, carrying a singleton fetus at term, scheduled to undergo cesarean section under spinal anesthesia were randomized in one of the two groups. Group BC (n = 30) received 10 mg hyperbaric bupivacaine and 75 &#956;g clonidine; Group BM (n = 30) 10 mg hyperbaric bupivacaine and 100 &#956;g morphine.  Results:  Statistically significant difference, p = 0.02, were found between the time of 14.5 ± 2.1 hours since the administration of anesthesia to the application of the first dose of additional analgesia in morphine group vs. clonidine group 8.18 ± 2.91 hours. Pain at the time of the application of postoperative analgesia was superior in clonidine group with 6.4 ± 1.0 points in AVE vs. morphine with 0.93 ± 2.4 points. p = 0.001. AVE values were also significantly higher for clonidine in relation to morphine at 6, 12 and 18 hours. No significant hemodynamic and respiratory changes occurred in either group. For morphine the most frequent side effect was itching in 66.7 % of patients. The level of sedation was the same for clonidine and morphine in all the patients.  Conclusions:  Add 100 &#956;g of morphine to hyperbaric bupivacaine for spinal anesthesia prolongs the time and significantly improves quality of the postoperative analgesic period greater than 75 &#956;g of clonidine. The most common side effect is itching.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Analgesia]]></kwd>
<kwd lng="en"><![CDATA[clonidine]]></kwd>
<kwd lng="en"><![CDATA[morphine]]></kwd>
<kwd lng="en"><![CDATA[cesarean section]]></kwd>
<kwd lng="es"><![CDATA[Analgesia]]></kwd>
<kwd lng="es"><![CDATA[clonidina]]></kwd>
<kwd lng="es"><![CDATA[morfina]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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