Documento de consenso sobre el uso de la combinación paracetamol/tramadol en pacientes con dolor moderado-intenso

  1. D. Samper Bernal 1
  2. A. Alvarado Bonilla 2
  3. L. Cánovas 3
  4. A. Carregal 4
  5. S.P. Fernández Sánchez 5
  6. J.M. González Mesa 6
  7. C. Guillén Astete 7
  8. A. Loscos López 8
  9. A.J. Lozano Martínez 9
  10. J.M. Pérez-Castejón 10
  11. G. Romero-Cullerés 11
  12. E. Salido de Andrés 12
  1. 1 Hospital Germans Trias i Pujol, Badalona, Barcelona, España
  2. 2 Hospital Jerez de la Frontera, Jerez de la Frontera, Cádiz, España
  3. 3 Complexo Hospitalario Universitario de Ourense, Orense, España
  4. 4 Complexo Hospitalario Universitario de Vigo, Vigo, España
  5. 5 Hospital de la Santa Creu i Sant Pau, Barcelona, España
  6. 6 Hospital Clínico Virgen de la Victoria, Málaga, España
  7. 7 Hospital Universitario Ramón y Cajal, Madrid, España
  8. 8 Hospital Arnau de Vilanova, Valencia, España
  9. 9 Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
  10. 10 Centro Sociosanitario El Carme, Badalona, Barcelona, España
  11. 11 Universitat Internacional de Catalunya (UIC), Manresa, Barcelona, España
  12. 12 UGC de Alcalá del Río, Sevilla, España
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Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Año de publicación: 2019

Número: 1

Páginas: 52-62

Tipo: Artículo

DOI: 10.1016/J.SEMERG.2018.08.004 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Semergen: revista española de medicina de familia

Resumen

Objetivos Desarrollar recomendaciones sobre el uso de la combinación paracetamol/tramadol (P/T) en pacientes con dolor moderado-intenso, basadas en la mejor evidencia y experiencia. Métodos Se siguió la metodología de grupos nominales y Delphi apoyados por una revisión sistemática de la literatura (RSL). Se seleccionó un panel multidisciplinar de 12 expertos en el manejo del dolor. En la primera reunión de grupo nominal se definió el objetivo, alcance, usuarios, apartados del documento de consenso, así como recomendaciones generales preliminares. Para la RSL se definieron los criterios de inclusión y exclusión, y las estrategias de búsqueda. Dos revisores seleccionaron y analizaron los artículos. Esta evidencia se discutió en una segunda reunión de grupo nominal y se generaron las recomendaciones definitivas. Para cada recomendación, el nivel de evidencia y el grado de recomendación se clasificaron según el modelo de Oxford, y el grado de acuerdo por técnica Delphi. Se definió acuerdo si al menos el 70% de los participantes contestaron ≥ 7 en cada recomendación (1 = total desacuerdo a 10 = total acuerdo). Resultados Se generaron 20 recomendaciones que cubren aspectos generales, como la evaluación del dolor, y específicos del manejo de P/T. Estos últimos abarcan la indicación de la combinación P/T (perfil de paciente, dosificación, pauta, formulaciones), gestión del riesgo (contraindicaciones, precauciones, interacciones, uso concomitante con otras medicaciones, seguimiento, situaciones especiales) y la educación del paciente. Conclusiones Estas recomendaciones pretenden resolver algunos interrogantes clínicos habituales y facilitar la toma de decisiones respecto al uso de la combinación P/T en pacientes con dolor moderado-intenso.

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