Fractura de Humero: Manejo de dolor en el tratamiento quirurgico realizado mediante bloqueo ecoguiado de plexo supraclavicular.
DOI:
https://doi.org/10.36557/2674-8169.2025v7n10p1157-1174Palavras-chave:
Fractura de húmero; bloqueo supraclavicular; plexo braquial; analgesia perioperatoria; ultrasonido.Resumo
Introducción: Las fracturas de húmero suponen una alta carga clínica y un reto analgésico perioperatorio; los bloqueos del plexo braquial, en especial el supraclavicular (SCB) ecoguiado, emergen como alternativa para reducir dolor y opioides. Objetivo: Describir y sintetizar la evidencia reciente sobre efectividad y seguridad del SCB ecoguiado como estrategia analgésica en cirugía por fractura de húmero. Metodología: Se realizó una revisión de artículos en la base de datos PubMed/MEDLINE, entre los años 2020 a 2025 en adultos sometidos a cirugía por fractura de humero; se incluyeron estudios sobre bloqueos periféricos ecoguiados. Resultados: El plexo se encuentra lateral a arteria subclavia, sobre primera costilla. Técnica en plano con 15–25 mL y adyuvantes (dexametasona/dexmedetomidina); el catéter continuo prolonga analgesia y reduce opioides. El SCB disminuye dolor y MME frente a manejo sistémico; el costoclavicular/infraclavicular ofrece analgesia equivalente con menor paresia frénica (ECA de bajo volumen: HDP 3.3% vs 36.7%). Operativamente, menos NVPO, alta ambulatoria factible (control hasta 72 h) y mejor rehabilitación temprana. Seguridad global favorable con ecografía; aplicar recomendaciones ASRA 2025 en anticoagulados. Conclusión: El SCB ecoguiado es eficaz y seguro; la elección debe individualizarse, priorizando abordajes infraclaviculares en riesgo respiratorio e integrando el bloqueo a protocolos ERAS. Se requieren ECA con desenlaces funcionales, evaluación en anticoagulados/EPOC y análisis de costo-efectividad.
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Copyright (c) 2025 Saskya Jamileth García Chavarría , Cristian Alejandro Rosas Montenegro , Alex Christopher Ruiz Arriciaga , Elizabeth Cristina Bastidas Vera , Ricardo Martín Reyes Egas
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.
