Eficacia analgésica de los antiinflamatorios no esteroideos en monoterapia frente a la analgesia multimodal basada en bloqueos regionales en el manejo del dolor agudo por trauma de extremidades inferiores: revisión sistemática de estudios publicados entre 2015 y 2026
DOI:
https://doi.org/10.71112/76xjxa39Palavras-chave:
Trauma, AINEs, Bloqueo, Analgesia, DolorResumo
El dolor agudo secundario a trauma de extremidades inferiores constituye una de las principales causas de consulta en los servicios de urgencias y representa un desafío clínico debido a su intensidad, complejidad fisiopatológica y necesidad de control analgésico oportuno. Aunque los antiinflamatorios no esteroideos (AINEs) han sido tradicionalmente utilizados como tratamiento de primera línea por su eficacia antiinflamatoria y perfil de seguridad a corto plazo, en los últimos años la analgesia multimodal basada en bloqueos regionales ha cobrado relevancia como estrategia superior y ahorradora de opioides. Se realizó una revisión sistemática siguiendo los lineamientos PRISMA 2020, mediante búsqueda en PubMed/MEDLINE, Scopus, Web of Science y Cochrane Library de estudios publicados entre 2015 y 2026. De 500 registros identificados, se incluyeron 20 estudios que evaluaron población adulta con trauma agudo de extremidades inferiores y medición objetiva del dolor mediante escalas validadas.
Los resultados muestran que los AINEs en monoterapia son eficaces en dolor leve a moderado, logrando reducciones clínicamente significativas en la intensidad del dolor; sin embargo, su potencia es limitada en casos de dolor severo o fracturas inestables. En contraste, los bloqueos regionales —como el femoral, fascia iliaca y PENG— demostraron mayor magnitud y rapidez en la reducción del dolor, así como menor consumo de opioides de rescate durante las primeras 24 horas. La evidencia sugiere que un modelo analgésico escalonado e individualizado, basado en la severidad del trauma y la intensidad del dolor, optimiza los resultados clínicos y reduce la exposición innecesaria a opioides.
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Copyright (c) 2026 José Francisco Miranda Bajaña, Diana Beatriz Aguirre Urrutia, Rafael Antonio Baez Borja, Alejandro Sebastián Grandes Padilla, Sandra Del Rocio Morocho Imbacuan (Autor/a)
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