Analgesia posquirúrgica con bupivacaína y morfina en cirugía de hombro mediante catéter intrarticular

introduction: decompressive surgery is relatively common in shoulder pain syndrome. postsurgical pain hampers the early rehabilitation of these patients and their reincorporation to work and social life. objective: dvaluate and demonstrate the efficacy of the use of the bupivacaine-morphine combination vs. bupivacaine alone, administered through an intra-articular catheter, for postoperative analgesia and rehabilitation in shoulder surgery. methods: an analytical prospective longitudinal study was conducted with 80 patients of both sexes aged 40-65 cared for at "dr. luis diaz soto" central military hospital in havana, which extended from october 2009 to may 2010. the patients were randomly distributed into 2 groups, each with 40 members. in group i, 2 mg of lyophilized morphine were added to the local anesthetic every 24 hours. in group ii, only 0.25 % bupivacaine (20 ml) was added every 6 hours. postoperative analgesia was evaluated with the analog visual scale (avs). results were compared by means of a chi-square test with a 95 % confidence degree. results: on average, prolongation of combined postoperative analgesia in group i was 13.5 hours vs. 4.55 hours in group ii, where only bupivacaine was used during the first 24 hours. a better evolution of pain was also observed in group i during the next 24 to 48 hours. conclusions: administration of the anesthetic mixture combined with the analgesic through an intra-articular catheter to relieve postoperative pain in shoulder surgery is more effective, with mild, easily manageable side effects, thus enabling early rehabilitation.