Efecto del diclofenaco tópico y oral sobre la tromboflebitis superficial inducida por infusión intravenosa
Andrea Becherucci, Daniel Bagilet
, José Marenghini, Mario Diab, Héctor Biancardi
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Servicio de Clínica Médica. Sanatorio Delta. Rosario. Argentina
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Sanatorio Delta. Rosario. Argentina" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. D. Bagilet. Zelaya 1536 (2000) Rosario." ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-09-08" "fechaAceptado" => "2000-01-04" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec220531" "palabras" => array:2 [ 0 => "Diclofenaco" 1 => "Tromboflebitis superficial" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hasta la actualidad los tratamientos propuestos para la tromboflebitis superficialinducida por infusion intravenosa (TFSI) son de dudosa eficacia y en su mayoria empiricos opoco documentados. El objetivo de este trabajo fue estudiar la efectividad y la seguridad de laadministracion topica de diclofenaco en el tratamiento de la TFSI.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Metodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En este trabajo prospectivo se incorporaron 120 pacientes de ambos sexos quedesarrollaron TFSI durante la hospitalizacion. Fueron asignados al azar a uno de los siguientes grupos:G-control (n = 40), sin tratamiento; G-topico (n = 40), diclofenaco emulgel, administrado enforma topica sobre la zona afectada cada 8 h durante 48 h, y G-oral (n = 40), diclofenaco 75 mgv.o. cada 12 h durante 48 h. Las mediciones se efectuaron en el momento del diagnostico de laTFSI (T0) y a las 48 h (T2). Se realizaron registros de la intensidad de la TFSI cuantificando rubor,tumor, calor y dolor. Dichos datos fueron comparados considerando los promedios de las diferenciasregistradas entre T2 y T0. Se considero como respuesta positiva al tratamiento una disminucionde la intensidad de la TFSI igual o superior al 30%. Las variables cuantitativas fueron estudiadascon ANOVA, test de Kruskal-Wallis o modelo lineal general y las cualitativas con el test de la χ<span class="elsevierStyleSup">2</span>, empleando el modelo de correccion de Yates. El nivel de significacion utilizado fue α = 0,05.RESULTADOS: Los promedios de las diferencias en la intensidad de la TFSI registradas entre T2 y T0en los grupos G-control, G-topico y G-oral fueron: –.0,12 (4,89), –.5,70 (3,13), –.4,82 (3,14) (p = 0,000). Las respuestas favorables en G-control, G-topico y G-oral fueron: 20, 60 y 60%, respectivamente(p = 0,0001). El numero de pacientes con efectos adversos en los grupos G-topico yG-oral fue: cefalea 9–5 (p = 0,2); epigastralgia 4–17 (p = 0,0009); nauseas 6–16 (p = 0,01), y pruritolocal 5–2 (p = 0,2). No se registraron reacciones adversas graves en ninguno de los grupos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La aplicacion topica de diclofenaco puede plantearse como una alternativa terapeuticasimple, efectiva y segura para los enfermos que desarrollan TFSI.</p> <span class="elsevierStyleSectionTitle">Background</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Until present time, suggested treatments for superficial thrombophlebitis inducedby intravenous infusion (TFSI), are of uncertain effectiveness and most of them or empiricaland not fully researched. The aim of this report is to study the effectiveness and safety of thetopical and oral administration of diclofenac in the treatment of TFSI.</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In this prospective study 120 patients both female and male were included.All of them developed TFSI during hospitalization and at the same time they were assignedat random to one of the following groups: G-control (n = 40), without treatment; G-topical (n =40), diclofenac emulsion gel used in a topical way on the concerned area every 8 hours during48 hours; G-oral (n = 40), diclofenac 75 mg p.o. every 12 hours during 48 hours. The measurementswere done at the moment of diagnosis of TFSI (T0) and 48 hours later (T2). Registries ofintensity of TFSI were done by quantifying flushing, tumor, heatness and pain. These data werecompared considering the averages of differences registered in T2 with respect to T0. A decreaseof intensity of TFSI . 30% was considered a positive answer to this treatment. The quantitativevariables were studied with ANOVA, Kruskal-Wallis test or general linear model and the qualitativewith the χ<span class="elsevierStyleSup">2</span> test with Yates correction. The level of significance used was α = 0.05.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The averages of differences in the intensity of TFSI that were registered in the groupsG-control, G-topical and G-oral in T2 compared to T0 are: –.0.12 (4.89), –.5.70 (3.13), –.4.82(3.14) (p = 0.000). The favorable answers in G-control, G-topical and G-oral were: 20, 60 and60%, respectively (p = 0.0001). The adverse reactions in G-topical and G-oral were: headache9–5 (p = 0.2), epigastric pain 4–17 (p = 0.0009), nausea 6–16 (p = 0.01) and local pruritus 5–2 (p = 0.2). The treatment did not report serious adverse reactions in either of the groups.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The topical treatment of diclofenac can be recommended as an alternative simple,effective and safe therapy for patients who develop TFSI.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subspecialty clinics: critical-care medicine. Infections related to central venous catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Corona" 1 => "S.G. Peters" 2 => "B.J. Narr" 3 => "R.L. 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| 2017 Junio | 36 | 9 | 45 |
| 2017 Mayo | 38 | 14 | 52 |
| 2017 Abril | 45 | 4 | 49 |
| 2017 Marzo | 29 | 48 | 77 |
| 2017 Febrero | 24 | 3 | 27 |
| 2017 Enero | 22 | 3 | 25 |
| 2016 Diciembre | 40 | 6 | 46 |
| 2016 Noviembre | 64 | 4 | 68 |
| 2016 Octubre | 71 | 5 | 76 |
| 2016 Septiembre | 45 | 7 | 52 |
| 2016 Agosto | 14 | 2 | 16 |
| 2016 Julio | 19 | 1 | 20 |
| 2016 Junio | 33 | 0 | 33 |
| 2016 Mayo | 34 | 6 | 40 |
| 2016 Abril | 29 | 0 | 29 |
| 2016 Marzo | 26 | 0 | 26 |
| 2016 Febrero | 29 | 1 | 30 |
| 2016 Enero | 19 | 0 | 19 |
| 2015 Diciembre | 30 | 1 | 31 |
| 2015 Noviembre | 31 | 0 | 31 |
| 2015 Octubre | 31 | 0 | 31 |
| 2015 Septiembre | 35 | 0 | 35 |
| 2015 Agosto | 36 | 0 | 36 |
| 2015 Julio | 24 | 0 | 24 |
| 2015 Junio | 18 | 0 | 18 |
| 2015 Mayo | 17 | 0 | 17 |
| 2015 Abril | 23 | 1 | 24 |
| 2015 Marzo | 15 | 0 | 15 |
| 2015 Febrero | 9 | 0 | 9 |
| 2015 Enero | 29 | 0 | 29 |
| 2014 Diciembre | 9 | 0 | 9 |
| 2014 Noviembre | 5 | 0 | 5 |
| 2014 Octubre | 4 | 0 | 4 |
| 2014 Septiembre | 1 | 0 | 1 |
| 2014 Agosto | 9 | 0 | 9 |
| 2014 Julio | 5 | 0 | 5 |
| 2014 Junio | 4 | 0 | 4 |
| 2014 Mayo | 1 | 0 | 1 |
| 2014 Abril | 4 | 0 | 4 |
| 2014 Marzo | 1 | 0 | 1 |
| 2014 Febrero | 3 | 0 | 3 |
| 2014 Enero | 7 | 0 | 7 |
| 2013 Diciembre | 5 | 0 | 5 |
| 2013 Noviembre | 7 | 0 | 7 |
| 2013 Octubre | 15 | 0 | 15 |
| 2013 Septiembre | 9 | 0 | 9 |
| 2013 Agosto | 11 | 0 | 11 |
| 2000 Marzo | 937 | 0 | 937 |
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