Browsing by Author "Vargas, Javiera"

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    Continuous peripheral nerve blocks for pain control after orthopaedic surgery
    (2025) Espinoza, Ana María; Leyton, Patricio A.; Robles, Marcia; Vargas, Javiera; Muñoz, Loreto A.
    BACKGROUND Continuous peripheral nerve blocks (CPNB) provide an opioid-free alternative for pain control after orthopaedic surgery. However, postdischarge ambulatory patient care and follow-up concerns have prevented CPNB use at home. OBJECTIVE To address physicians’ concerns about the outpatient use of CPNB. DESIGN Prospective, cohort, observational study. SETTING Single centre, teaching private hospital in Santiago, Chile, between July 2016 and March 2020. PATIENTS We included patients aged at least 18 who underwent orthopaedic surgery using CPNB for postoperative pain management. Patients scheduled simultaneously for non-orthopedic surgery on the same event were excluded. MAIN OUTCOME MEASURES Pain scores, opioid use, and complication rates at both in-hospital and at-home sites. RESULTS CPNB were provided as an analgesia plan in 497 patients who met inclusion criteria, and 387 (77.87%) were discharged home with this continuous analgesia. At 48 h, 70% of the patients reported no-worse-than-mild pain. Less than 3.1% of patients reported an episode of severe pain, and less than 13% of the patients required opioid rescue medication. Transient neurological symptoms were observed in 13% (95% confidence interval (CI), 10.4 to 16.1) of the patients. No long-term or severe complications were observed. High rates of satisfaction were reached among patients. CONCLUSION In-hospital and at-home use of CPNB supervised by a pain service team provides a feasible and safe alternative after orthopaedic surgery, pain control with a low requirement of opioids.
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    Fragilidad: en busca de herramientas de evaluación preoperatoria
    (2020) Vargas, Javiera; Gálvez, María de los Ángeles; Rojas, Mariana; Honorato, Macarena; Andrade, Maricarmen; Leyton, Patricio; Mardones, Gabriela; Morales, Julián; Pérsico, Daniela; Rojas, Fernanda; Moreno, Duby; Becker, Erika; Cavada, Gabriel; Carvajal, Cristóbal
    In the perioperative context, a frailty evaluation scale must consider certain characteristics such as validation, execution speed, simplicity, the capacity to measure multiple dimensions and not being dependent on a cognitive or physical test that could not be performed prior to surgery. The test should select patients that could benefit from interventions aimed to improve their postoperative outcomes. Aim: To validate two frailty evaluation scales for the perioperative period. Material and Methods: The Risk Analysis Index with local modifications (RAI-M) were applied to 201 patients aged 73 ± 7 years (49% women) and the Edmonton frailty scale were applied in 151 patients aged 73 ± 7 years (49% women) in the preoperative period. Their results were compared with the Rockwood frailty index. Results: The Edmonton frail scale showed adequate psychometric properties and assessed multiple dimensions through 8 of the 11 original questions, achieving a discrimination power over 80% compared to the Rockwood Index. The RAI- M, demonstrated solid psychometric properties with a tool that examines 4 dimensions of frailty through 15 questions and reviewing the presence of 11 medical comorbidities. This scale had a discrimination power greater than 85% and it was significantly associated with prolongation of the planned hospital stay and mortality. Conclusions: RAI-M is a short and easily administered scale, useful to detect frailty in the preoperative period

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