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Original article
Complications of continuous catheter analgesia for postoperative pain management in a tertiary care hospital. Incidence of technical complications and alternative analgesia methods used
Complicaciones de la analgesia continua invasiva para el control del dolor agudo postoperatorio en un hospital de tercer nivel. Incidencia de complicaciones técnicas y uso de métodos de analgesia alternativos
A. Recasensa,
Corresponding author
arecasga8@alumnes.ub.edu

Corresponding author.
, A. Hidalgob, A. Faulíb, C. Dürstelerb, M.J. Arguisb, C. Gomara,b
a Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, Spain
b Servicio de Anestesiología y Reanimación, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The correct management of acute post-operative pain has been shown to be a key factor for optimising postoperative recovery and reducing morbidity and convalescence&#46; Several studies have proven that inadequately treated pain can contribute to medical complications&#44; such as pneumonia&#44; deep vein thrombosis&#44; infection and depression&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Uncontrolled acute pain has also been associated with the development of chronic pain and decreased quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Therefore&#44; the provision of high-quality post-operative analgesia has recently become one of the main perioperative goals and hence an indicator of quality in perioperative care&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Despite the advancement of analgesic techniques&#44; the increasing use of minimally invasive surgeries and the implementation of enhanced recovery after surgery &#40;ERAS&#41; protocols&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> the management of postoperative pain remains a challenge&#46; Several studies conducted in the last decade show that up to 60&#37; of patients suffer moderate or severe pain after surgery&#44; indicating under-management of post-operative pain across the surgical spectrum&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There are multiple options when it comes to the treatment of postoperative pain&#44; with various drugs&#44; routes of administration and modalities being available&#46; Several evidence-based pain management guidelines have been published to offer general advice to clinicians&#44; such as the recent <span class="elsevierStyleItalic">Guidelines on the Management of Postoperative Pain</span> from the American Pain Society<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> or the <span class="elsevierStyleItalic">Practice Guidelines for Acute Pain Management in the Perioperative Setting</span> by the American Society of Anaesthesiologists&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Continuous catheter analgesia techniques &#40;CCAT&#41; provide a reasonable option for postoperative pain relief after major upper abdominal&#44; cardio-thoracic or orthopaedic surgeries&#44; amongst other procedures&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> In these cases&#44; continuous administration of analgesic drugs has been shown to be superior to intermittent administration&#44; as it reduces the incidence of break-through pain&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Like any invasive technique&#44; CCATs are not exempt from complications &#40;catheter displacement&#44; catheter obstruction&#44; pump failure&#44; &#8230;&#41;&#44; which may have detrimental effects on patients and their postoperative recovery process&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The use of CCATs is widespread in most hospitals&#44; and numerous studies have analysed their effectiveness in different surgical interventions&#44; the side effects of the drugs used&#44; and the impact of pain control on postoperative complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;12&#8211;16</span></a> However&#44; there is scant evidence on the intrinsic complications of CCATs and the effect that such complications may have on the quality of postoperative pain relief&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study is to determine the incidence of technical complications of CCATs in a tertiary care hospital&#44; where they are prescribed daily by anaesthesiologists from many different surgical services&#46; As secondary objectives&#44; we aim to describe the different postoperative CCATs used&#44; to analyse the effectiveness of these techniques&#44; to record and describe the analgesia regimens administered in case of failure of the primary CCAT&#44; and to evaluate the satisfaction of patients whose post-operative pain was managed with invasive techniques&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">The present study was a prospective observational study conducted over 4 months &#40;September 2017 to December 2017&#41; in the <span class="elsevierStyleItalic">Hospital Cl&#237;nic i Provincial de Barcelona</span> &#40;HCPB&#41;&#44; a tertiary care hospital&#46; All patients gave written informed consent during their preanesthetic appointment for data from their medical records to be used in the study&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study did not change any aspect of the clinical management of included and excluded patients&#44; and there was no direct intervention by the investigator&#46; Analgesic technique indication was left at the discretion of the responsible anaesthesiologist in each case&#46; Electronic pumps were used in patient-controlled analgesia &#40;PCA&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design</span><p id="par0045" class="elsevierStylePara elsevierViewall">All patients who received one of the following types of CCAT &#40;intravenous&#44; peridural or peripheral nerve block through an electronic PCA pump or elastomeric pump without PCA&#41; after any surgical procedure performed in the hospital were included in the study&#46; Patients reoperated during the follow-up period and&#47;or who were unable to comprehend the numerical rating scale &#40;NRS&#41; were excluded&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Data were collected over a period of 4 months &#40;September 2017 to December 2017&#41; at predefined weekly periods&#46; All consecutive patients who met the inclusion criteria were enrolled in the study&#44; and data were collected in the immediate postoperative period &#40;2 and 8<span class="elsevierStyleHsp" style=""></span>h after surgery&#41; and once daily until the primary CCAT &#40;or alternative secondary techniques&#41; was removed&#46; The sample size was estimated a priori in approximately 100 patients according an expected incidence of complications from 5&#37; to 25&#37;&#44; described in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">On the day of surgery&#44; data including patient demographics&#44; relevant comorbidities&#44; insufficient pain relief in previous surgeries&#44; and type of surgery were recorded on a predesigned form&#46; We also recorded the technique of postoperative analgesia prescribed&#44; drugs used in such technique&#44; and reported incidents during insertion of the catheters&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The first author &#40;A&#46;R&#46;&#41;&#44; together with the Acute Pain Service &#40;APS&#41; of the hospital&#44; performed subsequent patient follow-up&#46; We registered the assessment of pain intensity&#44; duration of the CCAT&#44; type of hospital unit &#40;intensive care&#44; high-dependency care&#44; conventional ward&#41;&#44; technical incidences&#44; and patient satisfaction regarding pain relief&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The average pain intensity was systematically assessed using a verbal NRS from 0 to 10&#44; where 0 is no pain and 10 is the worst pain imaginable at different postoperative data collection times &#40;2&#44; 8&#44; 24&#44; 48&#44; 72 and 96<span class="elsevierStyleHsp" style=""></span>h after the intervention&#41;&#46; We considered scores 0&#8211;3 to indicate mild pain&#44; 4&#8211;6 to indicate moderate pain&#44; and 7&#8211;10 to indicate severe pain&#46; The maximum pain score reported by the patients under the effect of any CCAT was recorded&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">When a technical complication occurred&#44; we noted the type of complication &#40;catheter displacement&#44; pump failure&#44; inflammation at the catheter insertion point&#44; insufficient&#47;excessive dosing of analgesic drugs&#44; patient misuse of the pump&#44; or insufficient information given to the patient&#41; and time since surgery&#46; The alternative analgesic technique provided as a rescue strategy in cases of CCAT removal due to complications together with the patient&#39;s pain intensity level until a successful analgesic alternative was achieved&#44; were recorded&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Patient satisfaction with the CCAT was evaluated at the time of removal of the device by completing a predesigned form&#46; Patients were required to rate on a 1&#8211;5 scale their satisfaction with the pain relief achieved with the CCAT&#44; their level of comfort with the technique&#44; their overall satisfaction&#44; and whether they would be willing to receive the same treatment in the future&#44; if required&#46; We also allowed patients to provide brief verbal feedback about their satisfaction with the CCAT&#44; which was recorded&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">The data were entered into Microsoft Excel<span class="elsevierStyleSup">&#174;</span> and analysed in SPSS<span class="elsevierStyleSup">&#174;</span> &#40;version 23&#41;&#46; Descriptive statistics analyses were performed on the main variables&#58; patient demographics&#44; type of surgery&#44; type of CCAT&#44; drugs prescribed&#44; and NRS pain score during postoperative follow-up&#46; A descriptive analysis was generated for levels of satisfaction with the pain relief provided by the CCAT&#44; level of comfort of the CCAT&#44; overall satisfaction&#44; and willingness to receive any form of CCAT for the management of postoperative pain if needed&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Comparative statistical analyses were performed between the group of patients who suffered a technical complication related to the CCAT and those who did not by performing a Student&#39;s <span class="elsevierStyleItalic">t</span>-test for selected variables&#46; The results with <span class="elsevierStyleItalic">p</span> values lower than 0&#46;05 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; were considered statistically significant&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">Over a period of 4 months&#44; data were collected on 106 consecutive patients at predefined weekly data collections times&#46; The baseline characteristics of the study population&#44; type of surgery&#44; and presence of poor pain control in previous operations are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Characteristics of CCATs</span><p id="par0095" class="elsevierStylePara elsevierViewall">Postoperative analgesia prescriptions were registered for all patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>106&#41;&#46; The mean duration of the CCAT was 47&#46;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#46;23<span class="elsevierStyleHsp" style=""></span>h&#46; During the follow-up period&#44; 52 patients &#40;49&#46;1&#37;&#41; were treated in conventional hospitalisation wards&#44; whereas 54 patients &#40;50&#46;9&#37;&#41; were treated in intensive or high-dependency care units&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Postoperative analgesia was provided by intravenous &#40;IV&#41; infusion with an electronic PCA pump in 64 patients&#44; and with an IV elastomeric pump in 21&#46; In the remaining cases&#44; other continuous techniques were used&#58; peridural PCA analgesia in 8 patients&#44; paravertebral block with PCA in 7 patients&#44; intercostal block with elastomeric pump plus IV electronic PCA in 5 patients&#44; and femoral block with elastomeric pump in 1 patient&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The analgesic modalities used for different surgical procedures are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Effectiveness of CCATs</span><p id="par0110" class="elsevierStylePara elsevierViewall">NRS scores at the different postoperative data collection times are shown In <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The maximum pain score reported by the patients under the effect of any CCAT was considered mild in 64 patients &#40;67&#46;92&#37;&#41;&#44; moderate in 25 patients &#40;23&#46;58&#37;&#41; and severe in 9 patients &#40;8&#46;49&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Technical complications of CCATs and impact on pain management</span><p id="par0115" class="elsevierStylePara elsevierViewall">We registered a total of 10 technical complications related to the CCATs in the study population during the follow-up period &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#44; representing 9&#46;43&#37; of the patients&#46; All 10 complications occurred using electronic PCA pumps&#46; No complications involving the intraoperative placement of the CCAT catheters were reported&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Of the 10 technical complications&#44; 3 were caused by displacement of the catheter&#44; 3 were related to inflammation at the insertion point of the IV catheter&#44; in 3 other cases there was an excessive dosing of the analgesic infusion&#44; and in 1 case the patient was unaware of how to operate the device due to insufficient information&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Most technical complications were detected within the first 24<span class="elsevierStyleHsp" style=""></span>h after the intervention &#40;7 out of 10&#41;&#44; with a mean detection time of 25&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16<span class="elsevierStyleHsp" style=""></span>h&#46; Inflammation at the catheter insertion point was the technical complication with the most delayed onset &#40;mean of 45&#46;3<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">A total of 4 complications had a reported impact on postoperative pain relief&#46; There were significant differences &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; in the maximum pain intensity reported by the complication and the non-complication groups &#40;4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8 vs&#46; 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">After the detection of a technical complication&#44; 50&#37; of the cases required the CCAT to be replaced by a multimodal IV regimen&#58; 1 out of 3 patients with catheter displacement&#44; 1 out of 3 patients with inflammation at the insertion point&#44; and all 3 patients who received excessive infusion dosing&#46; In the case of the patient who misused the PCA due to a lack of information about the technique&#44; the APS nurse taught him how to use the CCAT and ensured he had understood the information&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Patient satisfaction</span><p id="par0140" class="elsevierStylePara elsevierViewall">On the day of removal of the CCAT&#44; we evaluated satisfaction in 103 patients&#46; The parameters analysed and results are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; Three patients were unable to understand and&#47;or answer the questions on the form&#44; and were excluded&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Overall&#44; the vast majority &#40;95&#46;15&#37;&#41; of patients were satisfied with the CCAT&#44; 3&#46;88&#37; had were neutral&#44; and only 0&#46;97&#37; were dissatisfied&#46; The mean scores were 4&#46;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;73 for post-operative pain relief&#44; 4&#46;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;65 for convenience of the technique&#44; and 4&#46;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;62 as an overall satisfaction indicator&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">When comparing the satisfaction amongst patients who suffered a technical complication and those who did not&#44; significant differences were found in the scores related to convenience &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41; and overall satisfaction &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41; with the technique&#46; No significant differences were detected in respect of satisfaction with the pain relief&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Overall&#44; 94 out of 103 patients &#40;91&#46;26&#37;&#41; would be willing to receive the same postoperative analgesia in the future&#44; if required&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In the brief feedback section&#44; patients expressed their positive opinion of CCATs&#44; especially the autonomy provided by electronic PCA pumps&#46; A small proportion of patients reported discomfort due to the side-effects of the medication infused in the different CCATs&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0165" class="elsevierStylePara elsevierViewall">This prospective longitudinal study focused on a subject that&#44; to the best of our knowledge&#44; has not been widely analysed before&#58; the technical complications of CCAT as an entity&#44; and their impact in pain management and patient satisfaction&#46; In addition&#44; we also aimed to gather information about the profile of patients and type of surgery in which CCATs are being used in our centre&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">A total of 10 technical CCAT complications were identified&#44; representing a rate of 9&#46;43&#37;&#46; These complications neither caused harm to the patient nor affected the postsurgical outcome in any case&#46; However&#44; they had a negative effect on the quality of analgesia and patient&#39;s satisfaction with the analgesic method&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The complications associated with a technique should be weighed up against its benefits&#46; Our results show that CCATs provided successful post-operative pain relief&#46; The mean pain intensity score corresponded to mild pain &#40;NRS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>3&#41; at 2&#44; 8&#44; 24&#44; 48&#44; 72 and 96<span class="elsevierStyleHsp" style=""></span>h after surgery&#44; and less than 10&#37; reported severe pain in any moment of follow-up&#46; Pain intensity remained within satisfactory levels even at the peak of pain detected 24<span class="elsevierStyleHsp" style=""></span>h after the surgery&#44; in which the mean NRS was 2&#46;36<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;92&#46; This peak could be explained by several factors&#44; such as progressive recovery from the intraoperative analgesia and increased mobility&#46; These findings differ from data published in a study analysing adverse effects of IV CCATs&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> in which pain peaked in the first 0&#8211;6<span class="elsevierStyleHsp" style=""></span>h after surgery and was considerably higher&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The satisfactory pain control obtained in this study is one of its important contributions&#44; since insufficient management of post-operative pain has been reported by up to 60&#37; of patients in previous studies&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> It is striking that 43&#46;01&#37; of our study population reported poorly controlled pain after previous surgeries&#44; and these same patients obtained good pain relief with CCATs in this study&#46; It should also be noted that 93 out the 106 patients included had previously undergone surgery&#44; highlighting how prevalent surgery is in our environment&#46; The high prevalence of both surgical procedures and insufficient postoperative pain control justifies the performance of studies to define the effectivity and safety of postoperative analgesic techniques&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In this study&#44; the most frequently used CCATs in 64 patients &#40;60&#46;38&#37;&#41; were intravenous PCA modalities with electronic pumps&#44; with either morphine or a multimodal combination&#46; This technique has already been described as one of the main continuous invasive techniques used&#44; and has proved its efficacy in decreasing postoperative pain and increasing patient satisfaction&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> The second most common CCAT is multimodal IV analgesia administered with an elastomeric pump&#44; used on 21 patients &#40;19&#46;81&#37;&#41;&#46; Elastomeric pumps are simple and safe for the administration of IV multimodal combinations or local anaesthetics for neural blocks&#44; and their use is increasing&#46; In our study&#44; no technical complications were detected with elastomeric pumps&#46; Both IV techniques &#40;electronic PCA and elastomeric pumps&#41; were mainly used in cardiac surgery&#44; major abdominal and gynaecological surgeries&#44; as well as breast surgery&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">The remaining CCATs were used in regional techniques with local anaesthetics&#44; sometimes in combination with opioids&#46; These were less frequent and more dependent on the procedure performed&#46; This is in compliance the latest PROSPECT recommendations&#44; which are formulated to describe the best regional blocks techniques for management of postoperative pain&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> In this study&#44; peridural postoperative analgesia and continuous paravertebral nerve block were mainly used in thoracic surgery&#44; where they are currently the gold-standard for postoperative pain relief&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Nevertheless&#44; when less invasive cardio-thoracic surgery was performed&#44; less invasive CCATs such as continuous intercostal block combined with IV analgesia were applied&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Mean duration of CCATs was 47&#46;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#46;23<span class="elsevierStyleHsp" style=""></span>h&#59; there was no previously established period for their use&#46; The decision to remove the device is based on a regular assessment of pain&#44; side effects&#44; and the global situation of the patients&#46; The daily rounds of staff from the APS are useful to determine the most appropriate time for discontinuation of the CCAT according to pain control needs and reduction of avoidable technical complications&#44; mostly inflammation or possible catheter insertion point infection favoured by prolonged use&#46; It is interesting to note that 50&#37; of patients used CCATs in conventional hospitalisation wards&#44; with no minor or major medical complications&#46; Ensuring and maintaining this level of CCAT safety is primordial&#46; We believe that presence of the APS&#44; though fundamental&#44; cannot alone guarantee the absolute safety of these techniques&#46; Therefore&#44; educating and training all healthcare personnel in hospital wards on the use of CCATs&#44; as is done in our hospital&#44; is mandatory to guarantee the safety of this technique&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">The 9&#46;43&#37; rate of CCAT technical complications found in this study is moderately lower than that reported in previous studies<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;23&#44;24</span></a>&#59; however&#44; reported data need to be compared with caution&#44; as most publications only measure the incidence of non-technical complications or focus on a specific CCAT used in a specific procedure&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">In our view&#44; catheter displacements and accidental removal &#40;3 out of 106&#44; 2&#46;38&#37;&#41; are among the most important complications&#44; since they were associated with an increase in NRS score&#46; In 2 cases&#44; the catheter was repositioned and rescue IV or subcutaneous analgesia was provided&#46; In the remaining case&#44; CCAT was suspended and an IV multi-modal regimen was prescribed&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Catheter insertion point inflammation was observed in 2&#46;38&#37; of cases&#44; and was not associated with increased pain intensity&#46; All the cases involved IV catheters&#46; In 2 cases&#44; CCAT was continued after IV catheter replacement&#44; and in the other case CCAT was discontinued This complication could appear with any catheter&#44; even epidural or paravertebral&#44; and can be easily overlooked leading to potentially severe complications&#46; Catheter insertion site inflammation appears to be time-dependent in terms of onset and detection&#46; This highlights the importance of limiting as far as possible the duration of CCAT&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Excessive drug dosing was a complication detected in 3 patients&#46; In these cases&#44; satisfactory pain relief was provided but it was associated with unpleasant side-effects such as nausea and vomiting&#46; This resulted in severe discomfort and interfered with nutrition and oral medication&#46; CCATs were discontinued in all 3 cases and alternative IV multimodal intermittent analgesia was provided&#46; The variability of response to opiate dosing could explain the higher incidence of symptoms associated with excessive dosing in PCA morphine infusions compared to multimodal regimens&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">One patient did not receive or did not understand the necessary information to correctly operate the IV electronic PCA pump&#44; and his pain was poorly controlled&#46; Both elastomeric and electronic PCA pumps require a certain degree of understanding and collaboration from patients&#46; Electronic PCA pumps are easy to use&#44; but patients need to be taught how to self-administer additional doses&#44; if need be&#46; Elastomeric pumps also require instructions and recommendations to guarantee optimal performance&#46; Remerand et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> studied the in vivo reliability of elastomeric pumps&#44; and observed a dysfunction rate of 21&#46;84&#37; and increased pain scores when pump failure occurred&#46; In our hospital&#44; patients are recommended by the APS team to keep the infusers on their beds&#44; close to their body&#44; in order to optimise infusion conditions&#46; However&#44; due to partial sedation&#44; confusion&#44; or stress&#44; patients may not understand the instructions given&#46; Although these complications were not the most common&#44; they are probably the most avoidable&#46; Giving patients detailed yet easily understood instructions during pre-operative appointments could help correct this trend&#46; We believe that simple measures&#44; such as creating short&#44; patient-oriented video-tutorials about specific CCATs would be of great utility&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Regarding the impact of the technical complications on pain management&#44; we found statistically significant differences in the maximum pain scores between patients who suffered a technical complication and those who did not &#40;4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8 vs&#46; 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9 respectively&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#46; These findings illustrate the importance of maximising efforts to prevent technical complications and take prompt action when they are detected&#46; An efficient&#44; well-organised APS the key to obtaining the maximum benefit from CCATs and ensuring patient safety&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Patient satisfaction with CCAT was very high&#44; and the vast majority would be willing to receive the same CCAT to control acute postoperative pain if needed&#46; Nevertheless&#44; patients who suffered a technical complication showed less satisfaction with the specific technique and with the overall pain management strategy&#46; During collection of satisfaction data&#44; we noticed that some low scores were due to non-technical complications&#44; but the medication-induced side-effects were not systematically recorded in our study&#46; Patient satisfaction is a complex and multi-factorial variable influenced by objective and subjective factors&#46; It is extremely important&#44; because it provides physicians and other healthcare professionals with direct feedback on areas that can be improved to achieve high-quality post-operative care&#46; Additionally&#44; a number of patients rated the autonomy provided by the study analgesic techniques very highly&#44; especially PCA&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">There are some limitations in our study that should be taken into consideration&#46; First&#44; the collection of data in one single institution limits&#44; to an extent&#44; extrapolation of our results&#46; Complication rates were relatively small&#44; suggesting that a larger sample size would have provided more statistical power&#46; Nevertheless&#44; our study also has its strengths&#44; namely&#44; as its prospective design&#44; which allowed APS staff to collect all the data needed&#44; and the hospital&#39;s computerised patient management system&#44; which we believe is a complete and reliable source of information that all but eliminated the risk of omitting important complications&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">In conclusion&#44; CCATs after major surgery and certain less invasive procedures presented technical complications that had a negative impact on pain control and patient satisfaction in 9&#46;43&#37; of cases&#46; Catheter displacements have the greatest impact on pain relief&#44; whereas IV insertion point inflammation and excessive dosing of drugs are potentially the most dangerous complications&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0250" class="elsevierStylePara elsevierViewall">None of the authors has conflicts of interest to disclose&#46;</p></span></span>"
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              "titulo" => "Characteristics of CCATs"
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              "titulo" => "Effectiveness of CCATs"
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              "titulo" => "Technical complications of CCATs and impact on pain management"
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              "titulo" => "Patient satisfaction"
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    "fechaRecibido" => "2018-05-07"
    "fechaAceptado" => "2018-08-27"
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            0 => "Postoperative pain"
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            2 => "Technical complication"
            3 => "Continuous catheter analgesia"
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            0 => "Dolor postoperatorio"
            1 => "Analgesia"
            2 => "Complicaci&#243;n t&#233;cnica"
            3 => "Analgesia continua invasiva"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Continuous invasive analgesia remains the gold-standard method for managing acute post-operative pain after major surgery&#46; However&#44; this procedure is not exempt from complications that may have detrimental effects on the patient and affect the post-operative recovery process&#46; Data of the complications of continuous catheter analgesic techniques &#40;CCATs&#41; and their impact on pain relief are scarce in the literature&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a prospective longitudinal study and patients who underwent a surgical procedure and received continuous invasive analgesia after surgery were included&#46; Post-operative analgesic strategy&#44; pain scores &#40;NRS&#41;&#44; CCAT&#39;s characteristics and technical complications were recorded&#46; Patient satisfaction was determined&#46; Descriptive statistics and Student&#39;s <span class="elsevierStyleItalic">t</span>-tests were applied for the comparative analyses&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We collected data from 106 patients&#46; Mean duration of the CCAT was 47&#46;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#46;23<span class="elsevierStyleHsp" style=""></span>h and 52 patients &#40;49&#46;1&#37;&#41; were controlled in conventional hospitalisation units whereas 54 patients &#40;50&#46;9&#37;&#41; were controlled on intensive or high-dependency care units&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The overall incidence of technical complications was 9&#46;43&#37;&#46; The most common complications were catheter displacement &#40;2&#46;38&#37;&#41;&#44; inflammation at the IV catheter insertion point &#40;2&#46;38&#37;&#41; and excessive dosing of analgesic drugs &#40;2&#46;38&#37;&#41;&#46; Mean NRS scores were &#8804;3 during the permanence of CCATs&#46; Maximum pain intensity was significantly higher in patients who suffered technical complications &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#91;x&#175;&#177;&#8201;SD&#93;&#58; 4&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8 vs&#46; 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Satisfaction levels with the technique and overall satisfaction with the pain management strategy were negatively impacted by the occurrence of complications&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The incidence of technical complications of CCATs was 9&#46;43&#37; and had a negative impact in pain control and patient&#39;s satisfaction&#46;</p></span>"
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            "identificador" => "abst0005"
            "titulo" => "Background"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
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          2 => array:2 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La analgesia continua invasiva es el m&#233;todo de referencia para el manejo del dolor postoperatorio en cirug&#237;a mayor pero no est&#225; exenta de posibles complicaciones&#46; Existe poca informaci&#243;n sobre las complicaciones de las t&#233;cnicas analg&#233;sicas continuas con cat&#233;ter &#40;TACC&#41; y su impacto en el control del dolor&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;amos un estudio prospectivo longitudinal incluyendo a pacientes tratados mediante cirug&#237;a que recibieron una TACC postoperatoria&#46; Se registraron el tipo de analgesia&#44; la intensidad del dolor mediante escala NRS&#44; las caracter&#237;sticas de las TACC&#44; sus complicaciones t&#233;cnicas y la satisfacci&#243;n de los pacientes&#46; Se aplic&#243; estad&#237;stica descriptiva y an&#225;lisis comparativo mediante t de Student&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se registraron datos de 106 pacientes&#46; La duraci&#243;n de las TACC fue 47&#44;52 &#177; 21&#44;23 h&#59; 52 pacientes &#40;49&#44;1&#37;&#41; fueron controlados en hospitalizaci&#243;n convencional y 54 &#40;50&#44;9&#37;&#41; en unidades de cr&#237;ticos o alta dependencia&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La tasa global de complicaciones t&#233;cnicas fue del 9&#44;43&#37;&#46; Las complicaciones m&#225;s frecuentes fueron desplazamiento del cat&#233;ter &#40;2&#44;38&#37;&#41;&#44; inflamaci&#243;n en el punto de inserci&#243;n del cat&#233;ter IV &#40;2&#44;38&#37;&#41; y dosificaci&#243;n excesiva de analg&#233;sicos &#40;2&#44;38&#37;&#41;&#46; El valor medio de NRS fue &#8804; 3 durante la permanencia de la TACC&#46; La intensidad m&#225;xima de dolor fue mayor en los pacientes con complicaciones t&#233;cnicas &#40;media &#177; desviaci&#243;n est&#225;ndar &#91;x&#773; &#177; DE&#93;&#58; 4&#44;4 &#177; 2&#44;8 vs&#46; 2&#44;9 &#177; 1&#44;9&#59; p &#60; 0&#44;05&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La satisfacci&#243;n con la comodidad de la t&#233;cnica y la satisfacci&#243;n global con el tratamiento del dolor se redujeron significativamente en presencia de complicaciones&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La incidencia de complicaciones t&#233;cnicas de las TACC fue del 9&#44;43&#37; y tuvieron un impacto negativo en el control del dolor postoperatorio y en la satisfacci&#243;n de los pacientes&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Recasens A&#44; Hidalgo A&#44; Faul&#237; A&#44; D&#252;rsteler C&#44; Arguis MJ&#44; Gomar C&#46; Complicaciones de la analgesia continua invasiva para el control del dolor agudo postoperatorio en un hospital de tercer nivel&#46; Incidencia de complicaciones t&#233;cnicas y uso de m&#233;todos de analgesia alternativos&#46; Rev Esp Anestesiol Reanim&#46; 2019&#59;66&#58;84&#8211;92&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age &#40;years&#41;&#44; mean</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#46;84<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Weight &#40;kg&#41;&#44; mean</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gender &#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#91;56&#46;6&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#91;43&#46;4&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Obesity&#58; BMI</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">30 &#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#91;71&#46;7&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Diabetes &#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#91;28&#46;3&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#91;71&#46;7&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Renal impairment&#58; creatinine</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;1&#46;3</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mg&#47;dL &#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#91;12&#46;3&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Type of surgery &#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiac surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#91;39&#46;6&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Abdominal and gynaecological surgery &#40;laparotomy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#91;17&#46;9&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lung surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#91;13&#46;2&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Breast surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#91;7&#46;5&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Abdominal and gynaecological surgery &#40;laparoscopy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#91;5&#46;7&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Orthopaedic surgery of lower limbs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#91;5&#46;7&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Orthopaedic surgery of upper limbs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#91;3&#46;8&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Spine surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#91;3&#46;8&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Esofaguectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#91;2&#46;8&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Uncontrolled or severe pain in previous surgeries</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">&#40;number&#41; &#91;&#37;&#93;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#91;43&#46;01&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#91;56&#46;99&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Patients who underwent a surgical procedure in the past &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>93&#41;&#46;</p>"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics&#44; type of surgery performed and pain management in previous surgeries &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>106&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Type of surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of CCAT</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IV Elast&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Peridural electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Paravertebral block electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intercostal block<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Femoral block Elast&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal&#47;gynaecological &#40;laparotomy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lung&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Breast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal&#47;gynaecological &#40;laparoscopy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Orthopaedic &#40;lower limb&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Orthopaedic &#40;upper limb&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Spine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Esophagectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TOTAL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CCATs for postoperative pain control according to type of surgery &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>106&#41;&#46;</p>"
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        "etiqueta" => "Table 3"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Time after surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Study population &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>106&#41;</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients without complications &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>96&#41;</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients with complications &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients assessed &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NRS &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients assessed &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NRS &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patients assessed &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NRS &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;87<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;73<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">24<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;36<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">48<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">96<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of complication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of CCAT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Time of detection &#40;hours after surgery&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CCAT discontinuation due to technical complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alternative analgesia technique&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Other measures taken&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Poor pain relief due to technical complication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Time spent with NRS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>3 after the complication &#40;h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter displacement or accidental removal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Repositioning of catheter and rescue analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter displacement or accidental removal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peridural electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Repositioning of catheter and rescue analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter displacement<br>or accidental removal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peridural electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multimodal intermittent IV analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insertion point inflammation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter replacement and change of venous access&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insertion point inflammation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter replacement and change of venous access&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Insertion point inflammation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multimodal intermittent IV analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter replacement and change of venous access&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Excessive dosing of analgesic infusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multimodal intermittent IV analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Excessive dosing of analgesic infusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multimodal intermittent IV analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Excessive dosing of analgesic infusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Peridural electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Multimodal intermittent IV analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Temporary suspension of electronic pump&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Patient misuse due to insufficient information on the CCAT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV electronic PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Providing information about the CCAT and its functioning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of postoperative analgesia on major postoperative complications&#58; a systematic update of the evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;S&#46; Liu"
                            1 => "C&#46;L&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/01.ane.0000255040.71600.41"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2007"
                        "volumen" => "104"
                        "paginaInicial" => "689"
                        "paginaFinal" => "702"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17312231"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improving the management of post-operative acute pain&#58; priorities for change"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Meissner"
                            1 => "F&#46; Coluzzi"
                            2 => "D&#46; Fletcher"
                            3 => "F&#46; Huygen"
                            4 => "B&#46; Morlion"
                            5 => "E&#46; Neugebauer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2015.1092122"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2015"
                        "volumen" => "31"
                        "paginaInicial" => "2131"
                        "paginaFinal" => "2143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26359332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Persistent postsurgical pain&#58; risk factors and prevention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Kehlet"
                            1 => "T&#46;S&#46; Jensen"
                            2 => "C&#46;J&#46; Woolf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(06)68700-X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2006"
                        "volumen" => "367"
                        "paginaInicial" => "1618"
                        "paginaFinal" => "1625"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16698416"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative pain control"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Garimella"
                            1 => "C&#46; Cellini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0033-1351138"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Colon Rectal Surg"
                        "fecha" => "2013"
                        "volumen" => "26"
                        "paginaInicial" => "191"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24436674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enhanced Recovery After Surgery &#40;ERAS&#41; for gastrointestinal surgery&#44; part 2&#58; consensus statement for anaesthesia practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Feldheiser"
                            1 => "O&#46; Aziz"
                            2 => "G&#46; Baldini"
                            3 => "B&#46;P&#46;B&#46;W&#46; Cox"
                            4 => "K&#46;C&#46;H&#46; Fearon"
                            5 => "L&#46;S&#46; Feldman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/aas.12651"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Anaesthesiol Scand"
                        "fecha" => "2016"
                        "volumen" => "60"
                        "paginaInicial" => "289"
                        "paginaFinal" => "334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26514824"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence&#44; patient satisfaction&#44; and perceptions of postsurgical pain&#58; results from a US national survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;J&#46; Gan"
                            1 => "A&#46;S&#46; Habib"
                            2 => "T&#46;E&#46; Miller"
                            3 => "W&#46; White"
                            4 => "J&#46;L&#46; Apfelbaum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2013.860019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2014"
                        "volumen" => "30"
                        "paginaInicial" => "149"
                        "paginaFinal" => "160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24237004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of postoperative pain&#58; a clinical practice guideline from the American Pain Society&#44; the American Society of Regional Anesthesia and Pain Medicine&#44; and the American Society of Anesthesiologists&#8217; Committee on Regional Anesthesia&#44; Executive Committee&#44; and Administrative Council"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Chou"
                            1 => "D&#46;B&#46; Gordon"
                            2 => "O&#46;A&#46; de Leon-Casasola"
                            3 => "J&#46;M&#46; Rosenberg"
                            4 => "S&#46; Bickler"
                            5 => "T&#46; Brennan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpain.2015.12.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pain"
                        "fecha" => "2016"
                        "volumen" => "17"
                        "paginaInicial" => "131"
                        "paginaFinal" => "157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26827847"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practice guidelines for acute pain management in the perioperative setting&#58; an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Society of Anesthesiologists"
                          "etal" => false
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ALN.0b013e31823c1030"
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                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2012"
                        "volumen" => "116"
                        "paginaInicial" => "248"
                        "paginaFinal" => "273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22227789"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "CD004088"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-controlled intravenous opioid analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Werawatganon"
                            1 => "S&#46; Charuluxanun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD004088.pub2"
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procedure-specific pain management and outcome strategies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;P&#46; Joshi"
                            1 => "S&#46;A&#46; Schug"
                            2 => "H&#46; Kehlet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bpa.2014.03.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Anaesthesiol"
                        "fecha" => "2014"
                        "volumen" => "28"
                        "paginaInicial" => "191"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24993439"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Specific clinical situations&#58; postoperative pain"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;E&#46; Macintyre"
                            1 => "S&#46;A&#46; Schug"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "4th ed&#46;"
                        "titulo" => "Acute pain management&#58; a practical guide"
                        "fecha" => "2014"
                        "editorial" => "CRC Press"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and characterization of postoperative pain in the Postanaesthesia Care Unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Cabedo"
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                            2 => "A&#46; Alc&#243;n"
                            3 => "C&#46; Gomar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.redar.2016.11.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim"
                        "fecha" => "2017"
                        "volumen" => "64"
                        "paginaInicial" => "375"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28363327"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-controlled analgesia in the management of postoperative pain"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Momeni"
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                            2 => "M&#46; de Kock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2165/00003495-200666180-00005"
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                        "tituloSerie" => "Drugs"
                        "fecha" => "2006"
                        "volumen" => "66"
                        "paginaInicial" => "2321"
                        "paginaFinal" => "2337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17181375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
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                0 => array:3 [
                  "comentario" => "CD005059"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery"
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                          "etal" => false
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                            0 => "M&#46; Nishimori"
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                            2 => "J&#46;H&#46; Low"
                          ]
                        ]
                      ]
                    ]
                  ]
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                      "doi" => "10.1002/14651858.CD005059.pub3"
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                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison between systemic analgesia&#44; continuous wound catheter analgesia and continuous thoracic paravertebral block"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            1 => "H&#46;A&#46; Hanna"
                            2 => "A&#46; Bernard"
                            3 => "C&#46; Girard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/EJA.0b013e328357e5a1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Anaesthesiol"
                        "fecha" => "2012"
                        "volumen" => "29"
                        "paginaInicial" => "524"
                        "paginaFinal" => "530"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22914044"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Ahmed"
                            1 => "R&#46; Khan"
                            2 => "N&#46; Latif"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/0970-9185.119137"
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                        "tituloSerie" => "J Anaesthesiol Clin Pharmacol"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "472"
                        "paginaFinal" => "477"
                        "link" => array:1 [
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              ]
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            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Epub 2013 Jun 7"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dislocation rates of perineural catheters&#58; a volunteer study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Marhofer"
                            1 => "P&#46; Marhofer"
                            2 => "L&#46; Triffterer"
                            3 => "M&#46; Leonhardt"
                            4 => "M&#46; Weber"
                            5 => "M&#46; Zeitlinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/aet198"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "2013"
                        "volumen" => "111"
                        "paginaInicial" => "800"
                        "paginaFinal" => "806"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23748198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous epidural analgesia&#58; analysis of efficacy&#44; side effects and risk factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;T&#46; Duarte"
                            1 => "C&#46; Fernandes Mdo"
                            2 => "M&#46;J&#46; Fernandes"
                            3 => "R&#46;A&#46; Saraiva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Bras Anestesiol"
                        "fecha" => "2004"
                        "volumen" => "54"
                        "paginaInicial" => "371"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19471745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative pain intravenous patient-controlled analgesia-related adverse effects in young elderly patients&#58; a retrospective analysis of 10&#44;575 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;C&#46; Koh"
                            1 => "J&#46; Lee"
                            2 => "S&#46;Y&#46; Kim"
                            3 => "S&#46; Choi"
                            4 => "D&#46;W&#46; Han"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0000000000002008"
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2015"
                        "volumen" => "94"
                        "paginaInicial" => "e2008"
                        "itemHostRev" => array:3 [
                          "pii" => "S0885392416000683"
                          "estado" => "S300"
                          "issn" => "08853924"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-controlled analgesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Grass"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anaesth Analg"
                        "fecha" => "2005"
                        "volumen" => "101"
                        "numero" => "Suppl"
                        "paginaInicial" => "S44"
                        "paginaFinal" => "S61"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PROSPECT&#58; evidence-based&#44; procedure-specific postoperative pain management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Kehlet"
                            1 => "R&#46;C&#46; Wilkinson"
                            2 => "H&#46;B&#46; Fischer"
                            3 => "F&#46; Camu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Anaesthesiol"
                        "fecha" => "2007"
                        "volumen" => "21"
                        "paginaInicial" => "149"
                        "paginaFinal" => "159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17489225"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Epub 2016 May 30"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous paravertebral block for post-cardiothoracic surgery analgesia&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Scarfe"
                            1 => "S&#46; Schuhmann-Hingel"
                            2 => "J&#46;K&#46; Duncan"
                            3 => "N&#46; Ma"
                            4 => "Y&#46;N&#46; Atukorale"
                            5 => "A&#46;L&#46; Cameron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ejcts/ezw168"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2016"
                        "volumen" => "50"
                        "paginaInicial" => "1010"
                        "paginaFinal" => "1018"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27242357"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications and interventions associated with epidural analgesia for postoperative pain relief in a tertiary care hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Shafiq"
                            1 => "M&#46; Hamid"
                            2 => "K&#46; Samad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Middle East J Anaesthesiol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "827"
                        "paginaFinal" => "832"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21526668"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of peripheral nerve blocks"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;L&#46; Jeng"
                            1 => "T&#46;M&#46; Torrillo"
                            2 => "M&#46;A&#46; Rosenblatt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/aeq273"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "2010"
                        "volumen" => "105"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "i97"
                        "paginaFinal" => "i107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21148659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elastomeric pump reliability in post-operative regional anesthesia&#58; a survey of 430 consecutive devices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Remerand"
                            1 => "A&#46;S&#46; Vuitton"
                            2 => "M&#46; Palud"
                            3 => "S&#46; Buchet"
                            4 => "X&#46; Pourrat"
                            5 => "J&#46; Fusciardi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ane.0b013e 87c9bb 3181"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2008"
                        "volumen" => "107"
                        "paginaInicial" => "2079"
                        "paginaFinal" => "2084"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19020162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Establishing a nurse-based&#44; anesthesiologist-supervised inpatient acute pain service&#58; experience of 4&#44;617 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Shapiro"
                            1 => "E&#46; Zohar"
                            2 => "M&#46; Kantor"
                            3 => "J&#46; Memrod"
                            4 => "B&#46; Fredman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jclinane.11.002 2003"
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                        "tituloSerie" => "J Clin Anesth"
                        "fecha" => "2004"
                        "volumen" => "16"
                        "paginaInicial" => "415"
                        "paginaFinal" => "420"
                        "link" => array:1 [
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