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CASO CLÍNICO
Bloqueo del plano del músculo erector de la columna para analgesia de dolor lumbar crónico: serie de casos
Erector spinae plane block for chronic low back pain analgesia: A case series
I. Gonçalves Morais
Autor para correspondencia
inesmorais2011@gmail.com

Autor para correspondencia.
, A. Barreira Martins
Departamento de Anestesiología, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
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2&#41; fisioterapia&#44; 3&#41; opciones farmacol&#243;gicas tales como antiinflamatorios no esteroideos&#44; opioides y antidepresivos&#44; 4&#41; intervenciones psicol&#243;gicas y&#44; de indicarse&#44; 5&#41; tratamientos invasivos &#40;inyecciones&#44; cirug&#237;a&#44; entre otros&#41;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; A menudo es dif&#237;cil gestionar este tipo de dolor multifactorial a pesar de todas las intervenciones mencionadas&#44; con insatisfacci&#243;n acusada del paciente&#44; ansiedad e impacto en su vida diaria<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El bloqueo ecoguiado del plano del m&#250;sculo erector de la columna ecoguiado &#40;ESP&#41; consiste en un bloqueo interfascial cuyo objetivo es situar un anest&#233;sico local entre el m&#250;sculo erector de la columna y el proceso transverso de la v&#233;rtebra&#44; y difundirlo a las ramas ventral y dorsal del nervio espinal&#46; De hecho&#44; fue descrito originalmente por Forero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> como una t&#233;cnica simple y segura en el plano interfascial que consegu&#237;a alivio del dolor neurop&#225;tico tor&#225;cico&#46; Desde entonces se ha ido incrementando su uso para el tratamiento del dolor agudo&#44; como en cirug&#237;as de la columna lumbar<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">5&#44;6</span></a> y situaciones de dolor cr&#243;nico<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">4&#44;7</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Bas&#225;ndonos en todos los desarrollos cient&#237;ficos recientes con respecto a esta t&#233;cnica&#44; nuestro objetivo fue determinar la eficacia analg&#233;sica del bloqueo ecoguiado ESP en un grupo de pacientes con DLC de moderado a severo&#46; Describimos diez casos cl&#237;nicos diferentes que muestran respuestas individuales a este bloqueo para alivio del dolor&#44; en un periodo de hasta un mes posterior al procedimiento&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Recibimos la aprobaci&#243;n del Comit&#233; de &#201;tica para realizar el bloqueo ecoguiado ESP en un grupo de pacientes seleccionados&#44; con DLC de moderado a severo&#44; refractario a m&#250;ltiples terapias sist&#233;micas analg&#233;sicas&#46; Todos los pacientes realizaban seguimiento regular en la misma Cl&#237;nica del Dolor de un hospital terciario&#44; y fueron seleccionados consecutivamente&#46; Incluimos a pacientes adultos con DLC a largo plazo &#40;musculoesquel&#233;tico&#44; neurop&#225;tico y&#47;o quir&#250;rgico&#41;&#44; con espasmos y rigidez musculares paravertebrales&#44; y que eran refractarios al tratamiento farmacol&#243;gico&#44; con escala anal&#243;gica visual &#40;EVA&#41;<span class="elsevierStyleHsp" style=""></span>&#62;4&#44; sin contraindicaciones a la t&#233;cnica&#44; y que aportaron su consentimiento a la misma y al estudio&#46; La capacidad de acudir a nuestra cl&#237;nica del dolor y recibir tratamiento en la misma fue tambi&#233;n un criterio de selecci&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En esta serie de casos utilizamos un equipo SonoSite Edge II con sonda convexa de 2-5<span class="elsevierStyleHsp" style=""></span>MHz para realizar el bloqueo ecoguiado ESP&#46; La aguja elegida para todos los pacientes fue Echoplex-80<span class="elsevierStyleHsp" style=""></span>mm &#40;Vygon&#174;&#41; de calibre 22&#46; Los pacientes fueron monitorizados mediante ECG&#44; presi&#243;n arterial no invasiva&#44; pulsioximetr&#237;a y evaluaci&#243;n intravenosa previamente establecida&#46; Se practicaron los bloqueos bilateralmente a nivel lumbar &#40;L1-L2&#41;&#46; Con el paciente en posici&#243;n de dec&#250;bito prono &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; se coloc&#243; la sonda longitudinalmente con identificaci&#243;n &#243;ptima de los procesos transversos en el nivel deseado &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Utilizando una t&#233;cnica dentro de plano&#44; se avanz&#243; la aguja en direcci&#243;n cr&#225;neo-caudal hasta lograr el contacto con el hueso &#40;proceso transverso&#41;&#46; Tras confirmar la posici&#243;n adecuada de la aguja con una dosis peque&#241;a de anest&#233;sico local&#44; se inyectaron ropivaca&#237;na al 0&#44;2&#37; &#40;20<span class="elsevierStyleHsp" style=""></span>ml&#41; y dexametasona &#40;4<span class="elsevierStyleHsp" style=""></span>mg&#41; en cada lado&#44; en todos los pacientes menos uno &#40;1&#41; &#40;en el paciente n&#250;mero 1 se realiz&#243; bloqueo ecoguiado ESP derecho unilateral al nivel de L3&#44; ya que se quejaba solamente de dolor en ese lado &#40;se inyectaron 20<span class="elsevierStyleHsp" style=""></span>ml de ropivaca&#237;na al 0&#44;2&#37; y 4<span class="elsevierStyleHsp" style=""></span>mg de dexametasona&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Recopilamos datos prospectivos en tres momentos&#58; 1&#41; <span class="elsevierStyleItalic">antes de la intervenci&#243;n</span> datos demogr&#225;ficos&#44; &#237;ndice de masa corporal &#40;IMC&#41;&#44; antecedentes m&#233;dicos&#44; terapias actuales contra el dolor&#44; nivel de dolor EVA&#44; Brief Pain Inventory &#40;BPI&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> abreviado<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> y Neuropathic Pain Questionnaire &#40;DN4&#41;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a>&#59; 2&#41; <span class="elsevierStyleItalic">transcurridos 30 min de la intervenci&#243;n</span><span class="elsevierStyleUnderline">&#58;</span> nivel de dolor EVA y nivel de satisfacci&#243;n con la t&#233;cnica &#40;de 0&#58; &#171;totalmente insatisfecho&#187; a 10&#58; &#171;totalmente satisfecho&#187;&#41;&#59; 3&#41; transcurridos 24<span class="elsevierStyleHsp" style=""></span>h&#44; 72<span class="elsevierStyleHsp" style=""></span>h&#44; 7 d&#237;as y 1 mes de la intervenci&#243;n &#40;llamada telef&#243;nica&#41;&#58; complicaciones y nivel de dolor &#40;EVA&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los datos fueron recabados y examinados utilizando Microsoft Excel&#174; 15&#46;41&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">Realizamos el bloqueo ecoguiado ESP para DLC en diez pacientes seleccionados&#44; que fueron numerados del &#171;1&#187; al &#171;10&#187;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Caracterizaci&#243;n de los pacientes y dolor</span><p id="par0050" class="elsevierStylePara elsevierViewall">La mayor&#237;a de nuestros pacientes eran mujeres &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; 90&#37;&#41;&#44; y un &#250;nico var&#243;n&#46; El paciente m&#225;s joven ten&#237;a 52 a&#241;os&#44; y el mayor 88 a&#241;os &#40;media<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>70&#44;3&#59; desviaci&#243;n est&#225;ndar<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#44;63&#41;&#46; El &#237;ndice de masa corporal fue de 27&#44;211<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#40;desviaci&#243;n est&#225;ndar<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;71&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los pacientes ten&#237;a m&#225;s de una enfermedad cr&#243;nica&#44; que estaba asociada a polifarmacia&#44; a la cual contribu&#237;a la medicaci&#243;n para el dolor&#58; 9 pacientes tomaban m&#225;s de un tipo de f&#225;rmaco para aliviar el dolor &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Todos los pacientes seleccionados ten&#237;an dolor lumbar musculoesquel&#233;tico primario cr&#243;nico&#44; con arreglo a la clasificaci&#243;n International Association for the Study of Pain de dolor cr&#243;nico para la Clasificaci&#243;n Internacional de Enfermedades&#44; 11&#46;&#170; Revisi&#243;n &#40;ICD 11&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">El s&#237;ntoma principal era DL&#44; aunque 9 pacientes &#40;90&#37;&#41; reportaron tambi&#233;n dolor en otras localizaciones &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; Q2&#41;&#46; Durante la exploraci&#243;n f&#237;sica&#44; todos los pacientes ten&#237;an sensibilidad muscular paravertebral y dolor en el m&#250;sculo erector de la columna al ejercer presi&#243;n a nivel lumbar&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">En virtud de las respuestas al cuestionario BPI&#44; el 90&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41; de los pacientes hab&#237;a experimentado dolor severo &#40;EVA &#8805; 7&#41; en las &#250;ltimas 24 h&#44; el 40&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41; report&#243; que el dolor m&#237;nimo era moderado &#40;EVA &#8805;4&#41;&#44; el 40&#37; viv&#237;a con dolor severo&#44; y el 60&#37; restante con dolor moderado &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; Q3&#44;Q4&#44;Q5&#41;&#46; Los pacientes reportaron una media de solo el 34&#37; de alivio con la medicaci&#243;n para el dolor&#46; En cuanto a las actividades de la vida diaria&#44; se describi&#243; la actividad general como la m&#225;s afectada &#40;media de 6&#44;5 -<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; Q9A&#41;&#46; Las relaciones con otras personas y el sue&#241;o fueron los &#237;tems menos afectados por el dolor &#40;media de 3&#44;3&#41;&#59; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; Q9E&#44;F&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Aunque no exist&#237;an signos de radiculopat&#237;a en ning&#250;n paciente&#44; todos ellos reportaron uno o m&#225;s descriptores neurop&#225;ticos&#44; y el 50&#37; de ellos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; ten&#237;a &#8805; 4&#47;10 puntos en el Neuropathic Pain Questionnaire &#40;DN4&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Las respuestas a Brief Pain Inventory &#8211;forma abreviada&#8211; y Neuropathic Pain Questionnaire &#40;DN4&#41; se recogen en las <a class="elsevierStyleCrossRefs" href="#tbl0010">tablas 2 y 3</a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Evaluaci&#243;n posprocedimiento</span><p id="par0085" class="elsevierStylePara elsevierViewall">No se produjeron complicaciones para reportar durante el desempe&#241;o del bloqueo ecoguiado ESP ni durante la realizaci&#243;n del estudio&#46; Los resultados posprocedimiento inmediatos se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Las preguntas telef&#243;nicas se realizaron transcurridos 24<span class="elsevierStyleHsp" style=""></span>h&#44; 72<span class="elsevierStyleHsp" style=""></span>h&#44; 7 d&#237;as y 1 mes del bloqueo&#46; Los resultados de dichas preguntas se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; El paciente 2 dej&#243; de responder a nuestras llamadas al cabo de una &#40;1&#41; semana del procedimiento&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El bloqueo ecoguiado ESP ha sido reportado como un componente v&#225;lido de un plan analg&#233;sico multimodal para el dolor agudo y cr&#243;nico en las regiones tor&#225;cica&#44; lumbar y abdominal<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">4&#44;10&#44;11</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Las ventajas ampliamente mencionadas de dicho bloqueo son su facilidad y seguridad de desempe&#241;o&#44; debido a las referencias &#243;seas prontamente reconocibles y a la clara visualizaci&#243;n de la difusi&#243;n del AL<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46; El borde de la aguja se sit&#250;a lejos del eje neuroaxial&#44; por lo que existe un riesgo bajo de complicaciones que afecten a esta u otras estructuras vitales<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; Los riesgos potenciales tales como neumot&#243;rax&#44; hematoma y da&#241;o tisular han sido mencionados por Ahiskalioglu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a>&#46; De igual modo&#44; Tulgar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> reportaron cuatro complicaciones en su revisi&#243;n retrospectiva de 182 pacientes sometidos a bloqueo ecogiuado ESP&#44; consider&#225;ndose que todas ellas guardaban relaci&#243;n con la difusi&#243;n del AL en el plexo lumbar&#44; o la toxicidad sist&#233;mica del AL&#44; que pueden producirse al realizar otros tipos de t&#233;cnicas anest&#233;sicas regionales&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Aunque escasos&#44; los informes recientes de casos han establecido el &#233;xito analg&#233;sico del bloqueo ecoguiado ESP para el dolor de espalda cr&#243;nico&#44; como por ejemplo el dolor lumbar tras la cirug&#237;a de espalda<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a>&#44; o en el s&#237;ndrome de dolor miofascial dorsal<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#46; Sobre esta base&#44; decidimos realizar este bloqueo a nuestra poblaci&#243;n de pacientes ambulatorios&#44; dado que no lograban aliviar satisfactoriamente el dolor con tratamientos conservadores&#44; y el hallazgo de opciones alternativas era imperativo para mejorar su calidad de vida&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Nueve de nuestros casos hab&#237;an estado consumiendo fuertes opioides diariamente&#44; y aun as&#237; no hab&#237;an logrado niveles de dolor controlados&#58; el valor medio del nivel de dolor previo al bloqueo ecoguiado ESP fue de 6&#44;1 y el valor medio del nivel de dolor al acudir a la Cl&#237;nica del Dolor el d&#237;a del tratamiento fue de 7&#46; Tambi&#233;n refirieron poca mejora de la intensidad del dolor con los tratamientos continuos &#40;media del 34&#37; de alivio&#41;&#46; El dolor interfer&#237;a tambi&#233;n ampliamente en sus actividades diarias&#44; siendo la actividad general la m&#225;s afectada&#46; Las relaciones con otras personas y la interrupci&#243;n del sue&#241;o fueron las m&#225;s afectadas&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Realizamos mayoritariamente bloqueo ecoguiado ESP bilateral con 20<span class="elsevierStyleHsp" style=""></span>ml en cada lado&#46; Seg&#250;n la descripci&#243;n de Takahashi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> y Tulgar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> no existe a&#250;n una dosis recomendada de AL&#44; pero los vol&#250;menes de 30 a 40<span class="elsevierStyleHsp" style=""></span>ml fueron los mayoritariamente elegidos en diversos casos&#44; con buenos resultados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Tras el tratamiento los pacientes estuvieron muy satisfechos con la t&#233;cnica &#40;con una media de 8&#44;75 en el cuestionario de satisfacci&#243;n&#41;&#44; logr&#225;ndose un alivio inmediato y amplio del dolor &#40;nivel medio EVA de 2&#44;3&#41;&#46; Sin embargo&#44; debemos mencionar al paciente n&#250;mero 2&#44; con EVA de 7 tras el procedimiento&#44; quien&#44; aunque estaba muy satisfecho con el modo en que los investigadores realizaron el tratamiento&#44; no report&#243; alivio del dolor&#46; No se produjeron complicaciones ni efectos secundarios en este caso espec&#237;fico&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Los buenos resultados se mantuvieron transcurridas 24 y 72 h del tratamiento&#44; con niveles EVA medios de 3&#44;2 y 3&#44;1&#44; respectivamente&#46; Los resultados del 7&#46;&#176; d&#237;a y el 1&#46;<span class="elsevierStyleSup">er</span> mes guardan relaci&#243;n &#250;nicamente con 9 pacientes &#40;dado que el paciente n&#250;mero 2 abandon&#243; el estudio&#41;&#59; se produjo un nivel EVA medio de 3&#44;8 una semana posterior al tratamiento&#44; y de 6&#44;2 transcurrido un mes&#46; En general&#44; reportamos una duraci&#243;n media de 20&#44;8 d&#237;as &#40;con desviaci&#243;n est&#225;ndar de 8&#44;48&#41;&#59; en un &#250;nico caso existi&#243; una duraci&#243;n media de 3 d&#237;as&#59; y en el resto fue &#8805; 15 d&#237;as&#46; Como ya hemos mencionado&#44; no existieron complicaciones dignas de menci&#243;n&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">De manera similar a la que realizamos&#44; en un caso de dolor lumbar cr&#243;nico tras la cirug&#237;a de espalda&#44; Takahashi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> reportaron un alivio de 10<span class="elsevierStyleHsp" style=""></span>h tras el primer bloqueo&#44; que se repiti&#243; desde entonces tres veces en un mes con<span class="elsevierStyleHsp" style=""></span>&#62; 60&#37; de alivio del dolor&#46; En un caso de dolor tor&#225;cico cr&#243;nico&#44; Fusco et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> aliviaron el dolor durante 10 d&#237;as utilizando el bloqueo ecoguiado ESP como t&#233;cnica analg&#233;sica&#44; y Piraccini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> aliviaron el dolor durante 7 d&#237;as tras este bloqueo en el sacro&#44; lo cual permiti&#243; realizar tratamiento adicional &#40;inyecci&#243;n de esteroide transforaminal&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En un caso de dolor de hombro cr&#243;nico&#44; Forero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> lograron un alivio del dolor de hasta 12 semanas&#46; De manera interesante&#44; nuestro paciente n&#250;mero 6 mencion&#243; alivio del dolor de hombro durante m&#225;s de 30 d&#237;as tras el procedimiento&#46; Adem&#225;s&#44; se report&#243; analgesia continua exitosa tras la inserci&#243;n del cat&#233;ter en el plano interfascial para tratamiento del dolor cr&#243;nico<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">11&#44;17</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Bas&#225;ndonos en nuestro estudio y en todos los informes de casos presentados&#44; creemos que el bloqueo ecoguiado ESP tiene ventajas preliminares para el dolor lumbar cr&#243;nico&#58; 1&#41; se realiza f&#225;cilmente con bajo riesgo de complicaci&#243;n&#59; 2&#41; el paciente recibe el alta inmediata sin bloqueo motor&#59; 3&#41; existe un 100&#37; de eficacia a corto y medio plazo &#40;duraci&#243;n media de 20&#44;8 d&#237;as&#41;&#59; 4&#41; no existe incremento terap&#233;utico sist&#233;mico&#44; como fuertes opioides&#59; 5&#41; produce un buen periodo de tiempo de &#171;ventana terap&#233;utica&#187;&#58; tiempo para la realizaci&#243;n de rehabilitaci&#243;n f&#237;sica y ejercicio de los pacientes con niveles tolerables de dolor &#40;interrupci&#243;n del ciclo de dolor&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Considerando las respuestas de cada individuo al tratamiento de inyecci&#243;n &#250;nica y su duraci&#243;n&#44; las inyecciones repetidas y secuenciales o la t&#233;cnica continua mediante inserci&#243;n de cat&#233;ter podr&#237;an ser opciones para lograr un tiempo de mejora m&#225;s prolongado&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Una limitaci&#243;n importante de nuestro estudio es la enfermedad osteoarticular concomitante con implicaci&#243;n lumbar vista en nuestros pacientes&#44; especialmente los mayores&#44; dificultando la garant&#237;a de dolor miofascial absoluto&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; la limitaci&#243;n principal de esta serie de casos es que careci&#243; de aleatorizaci&#243;n&#44; ya que los pacientes fueron seleccionados por los autores&#44; y el tama&#241;o de la muestra presentado fue peque&#241;o&#46; No se trata de un estudio de casos-control&#44; lo cual limita su evidencia cient&#237;fica&#46; De igual modo&#44; como el seguimiento de los pacientes se realiz&#243; telef&#243;nicamente&#44; la recopilaci&#243;n de los datos puede estar restringida asimismo&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Son necesarios estudios futuros de casos-control aleatorizados incluyendo muestras m&#225;s amplias para concluir la eficacia del bloqueo ecoguiado ESP para el tratamiento del dolor lumbar cr&#243;nico&#44; y determinar su efectividad en los diferentes tipos de dolor lumbar&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0165" class="elsevierStylePara elsevierViewall">Las autoras declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "M&#233;todos"
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        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Caracterizaci&#243;n de los pacientes y dolor"
            ]
            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Evaluaci&#243;n posprocedimiento"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-11-15"
    "fechaAceptado" => "2020-06-25"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1400920"
          "palabras" => array:4 [
            0 => "Dolor cr&#243;nico"
            1 => "Dolor lumbar"
            2 => "Bloqueo del nervio"
            3 => "Anestesia regional"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1400921"
          "palabras" => array:4 [
            0 => "Chronic pain"
            1 => "Low back pain"
            2 => "Nerve block"
            3 => "Regional anesthesia"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El dolor lumbar cr&#243;nico &#40;DLC&#41; es una situaci&#243;n frecuente&#44; mal gestionada con tratamientos convencionales&#46; El bloqueo ecoguiado del plano del m&#250;sculo erector de la columna ha sido crecientemente utilizado para tratar el dolor agudo y cr&#243;nico&#46; Nuestro objetivo fue determinar la eficacia analg&#233;sica de esta t&#233;cnica en pacientes con DLC de moderado a severo&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron consecutivamente diez pacientes&#58; adultos&#44; con seguimiento regular en nuestra Cl&#237;nica del Dolor para DLC de moderado a severo a largo plazo&#44; refractario a tratamiento farmacol&#243;gico&#44; EVA<span class="elsevierStyleHsp" style=""></span>&#62;4&#46; Recopilaci&#243;n prospectiva de los datos&#58; antes de la intervenci&#243;n&#44; datos demogr&#225;ficos&#44; antecedentes m&#233;dicos&#44; terapias actuales para el dolor&#44; nivel de dolor EVA&#44; breve inventario del dolor &#40;Brief Pain Inventory&#41; abreviado&#44; y cuestionario de dolor neurop&#225;tico &#40;Neuropathic Pain Questionnaire&#41;&#59; transcurridos 30 minutos de la intervenci&#243;n&#44; EVA y nivel de satisfacci&#243;n&#59; transcurridos 24<span class="elsevierStyleHsp" style=""></span>h&#44; 72<span class="elsevierStyleHsp" style=""></span>h&#44; 7 d&#237;as y un mes&#44; complicaciones y nivel de dolor&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La muestra se compuso mayoritariamente de mujeres &#40;90&#37;&#41;&#44; con una edad media de 70&#44;3 a&#241;os&#46; Todas ellas ten&#237;an DLC musculoesquel&#233;tico primario&#46; El 90&#37; hab&#237;an experimentado dolor severo &#40;EVA<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; en las &#250;ltimas 24 horas&#46; El 50&#37; present&#243; caracter&#237;sticas neurop&#225;ticas&#46; Los pacientes estuvieron muy satisfechos con la t&#233;cnica &#40;media&#58; 8&#44;75&#41; con alivio inmediato del dolor &#40;EVA medio&#58; 2&#44;3&#41;&#46; Transcurridos 24<span class="elsevierStyleHsp" style=""></span>h&#44; 72<span class="elsevierStyleHsp" style=""></span>h&#44; 7 d&#237;as y un mes del tratamiento&#44; los valores medios de EVA fueron de 3&#44;2&#44; 3&#44;1&#44; 3&#44;8 y 6&#44;2&#46; Reportamos una duraci&#243;n media de 20&#44;8 d&#237;as&#44; sin complicaciones a corto o largo plazo&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discusi&#243;n y conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El bloqueo ESP ecoguiado tiene ventajas preliminares para el DLC&#58; se realiza f&#225;cilmente con bajo riesgo de complicaciones&#44; se procede al alta inmediata sin bloqueo motor&#44; con un 100&#37; de eficacia a corto y medio plazo&#46; Aunque el alivio del dolor fue inferior a un mes&#44; se trata de una t&#233;cnica &#250;til que permite al paciente experimentar bienestar&#44; y realizar rehabilitaci&#243;n f&#237;sica y ejercicio durante este periodo&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Discusi&#243;n y conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Chronic low back pain &#40;CLBP&#41; is a frequent condition&#44; poorly managed with conventional treatments&#46; The ultrasound-guided erector spinae plane block has increasingly been used in the management of acute and chronic pain&#46; We aimed to determine this technique&#39;s analgesic efficacy in patients with moderate to severe CLBP&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ten consecutively selected patients&#58; adults&#44; regularly followed in our Pain Clinic with moderate&#47;severe long-term CLBP refractory to pharmacological treatment&#44; VAS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>4&#46; Prospective data collection&#58; before the intervention &#8211;demographical data&#44; past medical history&#44; current pain therapies&#44; VAS pain level&#44; Brief Pain Inventory&#8211; Short Form and Neuropathic Pain Questionnaire&#59; 30<span class="elsevierStyleHsp" style=""></span>minutes after &#8211; VAS and satisfaction level&#59; 24 and 72<span class="elsevierStyleHsp" style=""></span>hours&#44; 7 days and 1 month after - complications and pain level&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Majority of females &#40;90&#37;&#41;&#44; mean age of 70&#46;3 years-old&#46; All had primary musculoskeletal CLBP&#46; 90&#37; experienced severe pain &#40;VAS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41; in the last 24<span class="elsevierStyleHsp" style=""></span>hours&#46; Half presented neuropathic characteristics&#46; Patients were very satisfied with the technique &#40;mean&#58; 8&#46;75&#41; with immediate pain relief &#40;VAS mean&#58; 2&#46;3&#41;&#46; 24 and 72<span class="elsevierStyleHsp" style=""></span>hours&#44; 7 days and 1 month after the treatment VAS means were 3&#46;2&#44; 3&#46;1&#44; 3&#46;8 and 6&#46;2&#46; We report a 20&#46;8 days duration mean&#46; No short or long-term complications&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion and conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Ultrasound-guided erector spinae plane block has preliminary advantages in CLBP&#58; easily performed with low complications risk&#44; immediate discharge home with absence of motor block&#44; 100&#37; efficacy at short and medium-terms&#46; Even though pain&#39;s relief was shorter than a month&#44; it is a useful tool allowing patients&#8217; well-being&#44; physical rehabilitation and exercise during this period&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Discussion and conclusions"
          ]
        ]
      ]
    ]
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        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1219
            "Ancho" => 1625
            "Tamanyo" => 280292
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Posicionamiento del bloqueo ESP &#40;paciente&#44; sonda&#44; aguja y ec&#243;grafo&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1223
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            "Tamanyo" => 253272
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Imagen ecogr&#225;fica del bloqueo ESP&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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            "rol" => "short"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes fueron insuficientemente medicados en el pasado con un sinf&#237;n de f&#225;rmacos no opioides&#46; Tambi&#233;n se probaron opioides fuertes o suaves&#44; o ambos&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Actualmente&#44; &#250;nicamente el paciente n&#250;mero 5 fue medicado con opioides suaves&#44; mientras que el resto utilizaba opioides fuertes&#44; o una conjunci&#243;n de ambos&#46; No se obtuvo alivio satisfactorio del dolor&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">MME&#58; equivalentes de miligramos de morfina oral &#40;diarios&#41;&#59; No O&#58; no opioides&#59; Of&#58; opioides fuertes&#59; Os&#58; opioides suaves&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                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" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Terapias previas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Terapia actual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;15 MME&#41;&#44; Of &#40;20 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Of &#40;40 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;120 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;84 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;10 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;15 MME&#41;&#44; Of &#40;100 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;22&#44;5 MME&#41;&#44; Of &#40;90 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Of &#40;60 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No O&#44; Of&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Os &#40;7&#44;5 MME&#41;&#44; Of &#40;160 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-O&#44; Of&#44; Os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Of &#40;160 MME&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2659399.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Terapias contra el dolor previas y actuales</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes reportaron dolor lumbar constante&#44; y en al menos otro &#225;rea corporal &#40;Q1&#44; Q2&#41;&#46; Q3&#44; Q4&#44; Q5 y Q6 demuestran&#44; respectivamente&#44; las peores&#44; m&#237;nimas&#44; medias y actuales puntuaciones de dolor&#46; Q7 hace referencia a la medicaci&#243;n actual para el dolor &#40;reflejada en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#44; y Q8 representa el alivio obtenido con ella en las &#250;ltimas 24<span class="elsevierStyleHsp" style=""></span>h&#46; Q9A-G caracteriza la interferencia del dolor en las &#250;ltimas 24<span class="elsevierStyleHsp" style=""></span>h en&#58; la actividad general&#44; humor&#44; ambulaci&#243;n&#44; trabajo normal&#44; relaciones con otras personas&#44; sue&#241;o y disfrute de la vida&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">M&#58; media&#59; P&#58; pacientes&#59; PR&#58; previamente respondido&#59; Q&#58; pregunta&#59; SD&#58; desviaci&#243;n est&#225;ndar&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q9A&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q9E&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q9F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q9G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">PR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2659400.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Breve inventario del dolor - BPI &#40;abreviado&#41;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">El 50&#37; de los pacientes puntuaron positivamente &#40;&#62;&#47;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41; el dolor neurop&#225;tico en el cuestionario DN4&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">P&#58; pacientes&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DN4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2659398.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Cuestionario de dolor neurop&#225;tico &#40;DN4&#41;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Inmediatamente tras el bloqueo ESP&#44; todos los pacientes estuvieron satisfechos con el procedimiento y la puntuaci&#243;n EVA media fue de 2&#44;3&#44; lo cual demuestra alivio satisfactorio del dolor&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; EVA&#58; Escala anal&#243;gica visual&#59; M&#58; media&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                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" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Satisfacci&#243;n cuestionario&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-EVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pos-EVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  """
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          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Las puntuaciones EVA medias fueron inferiores a 4 hasta el 7&#46;&#176; d&#237;a tras el bloqueo ESP&#46; Los resultados a un mes reflejaron una puntuaci&#243;n EVA media de 6&#44;2&#46; La mayor&#237;a de nuestros pacientes report&#243; alivio del dolor durante al menos 15 d&#237;as &#40;media&#58; 20&#44;8 d&#237;as&#41;&#46;</p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; EVA&#58; Escala anal&#243;gica visual&#59; M&#58; media&#59; NR&#58; no respuesta&#46;</p>"
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">EVA 24h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EVA 72h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EVA 7 d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EVA 1 mes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duraci&#243;n de la analgesia &#40;d&#237;as&#41;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 00349356
Idioma original: Español
DOI:10.1016/j.redar.2020.06.018
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