<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1561-3194</journal-id>
<journal-title><![CDATA[Revista de Ciencias Médicas de Pinar del Río]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ciencias Médicas]]></abbrev-journal-title>
<issn>1561-3194</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1561-31942020000500012</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Ventajas de la anestesia intravenosa libre de opioides en cirugía ambulatoria oncológica de mama]]></article-title>
<article-title xml:lang="en"><![CDATA[Advantages of opioid-free intravenous anesthesia over anesthesia in ambulatory breast cancer surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Garcia]]></surname>
<given-names><![CDATA[Omar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortega Valdés]]></surname>
<given-names><![CDATA[María Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ravelo Llanio]]></surname>
<given-names><![CDATA[Wilfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardenas Torres]]></surname>
<given-names><![CDATA[Yvonne Yolanda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valdés Miranda]]></surname>
<given-names><![CDATA[José Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Pinar del Río Hospital General Docente &#8220;Abel Santamaría Cuadrado&#8221; ]]></institution>
<addr-line><![CDATA[Pinar del Río ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Oncología y Radiobiología  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2020</year>
</pub-date>
<volume>24</volume>
<numero>5</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1561-31942020000500012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1561-31942020000500012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1561-31942020000500012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  la anestesia general libre de opioides surge ante la necesidad de evasión del uso de opioides en el transoperatorio y sus efectos indeseados en el posoperatorio.  Objetivo:  evaluar el comportamiento hemodinámico y la recuperación anestésica en pacientes intervenidas mediante cirugía ambulatoria por cáncer de mama, en las cuales se administró anestesia general total intravenosa libre de opioides o general balanceada.  Métodos: se realizó un estudio cuasiexperimental, prospectivo en pacientes a las que se aplicó anestesia general balanceada (n=34) y total intravenosa libre de opioides (n=34) intervenidas quirúrgicamente por cáncer de mama, en el Hospital General Docente &#8220;Abel Santamaría Cuadrado&#8221;, durante el 2018.  Resultados: el grupo de anestesia general balanceada mostró mayor variación intraoperatoria de los parámetros evaluados, con diferencias significativas (p=0,019). El tiempo medio de despertar fue menor en el grupo de anestesia total intravenosa (2,10 ± 0,907 min vs 5,35 ± 1,250 min; p&lt;0,01), al igual que el dolor, con diferencia significativa (p&lt;0,05) y el tiempo de recuperación, donde una hora después de la intervención, el 85 % cumplía los criterios de alta anestésica. El retraso en el alta de la unidad de recuperación ocurrió principalmente por el bajo nivel de actividad motora, con mayor incidencia en el grupo de anestesia general balanceada (71 % vs 26 %; p=0,00).  Conclusiones:  la anestesia total intravenosa libre de opioides fue superior al método general balanceado, pues mostró mayor estabilidad hemodinámica y analgesia, menor incidencia de complicaciones posoperatorias y menor tiempo de estancia en sala de recuperación posanestésica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  opioid-free general anesthesia arises from the need to avoid the use of opioids in the transoperative period and the undesirable effects in the postoperative period.  Objective:  to assess the hemodynamic behavior and anesthetic recovery in patients who underwent ambulatory surgery for breast cancer and those who were given either opioid-free intravenous general or balanced general anesthesia.  Methods:  a quasi-experimental, prospective study was carried out on patients who received balanced general anesthesia (n=34) and total opioid-free intravenous anesthesia (n=34), who underwent breast cancer surgery at Abel Santamaria Cuadrado General Teaching Hospital during 2018.  Results:  the group of balanced general anesthesia showed greater intraoperative variation of the parameters assessed, with significant differences (p=0.019). The mean time of awakening was lower in the intravenous total anesthesia group (2.10 ± 0,907 min vs. 5,35 ± 1,250 min; p&lt;0.01), as was pain, with significant difference (p&lt;0.05) and the recovery time, where one hour after the surgery, 85 % met the criteria for anesthesia discharge. The delay in discharge from the recovery unit occurred mainly because of the low level of motor activity, with a higher incidence in the group of balanced general anesthesia (71% vs. 26 %; p=0.00).  Conclusions:  intravenous opioid-free total anesthesia was higher to the balanced general approach because it showed greater hemodynamic and analgesic stability, lower incidence of postoperative complications, and shorter time spent in the post-anesthesia recovery room.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[ANESTESIA]]></kwd>
<kwd lng="es"><![CDATA[ANESTESIA Y ANALGESIA]]></kwd>
<kwd lng="es"><![CDATA[NEOPLASIAS DE LA MAMA]]></kwd>
<kwd lng="es"><![CDATA[ANESTESIA INTRAVENOSA]]></kwd>
<kwd lng="es"><![CDATA[ANESTESIA GENERAL]]></kwd>
<kwd lng="es"><![CDATA[ANESTESIA BALANCEADA]]></kwd>
<kwd lng="en"><![CDATA[ANESTHESIA]]></kwd>
<kwd lng="en"><![CDATA[ANESTHESIA AND ANALGESIA]]></kwd>
<kwd lng="en"><![CDATA[BREAST NEOPLASMS]]></kwd>
<kwd lng="en"><![CDATA[ANESTHESIA, INTRAVENOUS]]></kwd>
<kwd lng="en"><![CDATA[ANESTHESIA, GENERAL]]></kwd>
<kwd lng="en"><![CDATA[BALANCED ANESTHESIA]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Archundia García]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Cirugía 1. Educación quirúrgica]]></source>
<year>2017</year>
<edition>6</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[McGrawHill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas-Hernández]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia libre de opioides]]></article-title>
<source><![CDATA[Rev Mex Anestesiol]]></source>
<year>2014</year>
<volume>37</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>24-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chávez-Díaz]]></surname>
<given-names><![CDATA[IF]]></given-names>
</name>
<name>
<surname><![CDATA[Nava-López]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia libre de opioides. La reivindicación de los «adyuvantes»]]></article-title>
<source><![CDATA[Rev Mex Anestesiol]]></source>
<year>2015</year>
<volume>38</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>310-3</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beattie]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tisdale]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Current Opinion in Supportive and Palliative Care]]></article-title>
<source><![CDATA[Clinic mayo]]></source>
<year>2008</year>
<volume>2</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bakan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Umutoglua]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Topuza]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Uysala]]></surname>
<given-names><![CDATA[Harun]]></given-names>
</name>
<name>
<surname><![CDATA[Bayramb]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kadiogluc]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia venosa total libre de opiáceos, con infusiones de propofol, dexmedetomidina y lidocaína para la colecistectomía laparoscópica: estudio prospectivo, aleatorizado y doble ciego]]></article-title>
<source><![CDATA[Rev Bras Anestesiol]]></source>
<year>2015</year>
<volume>65</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>191-9</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mulier]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia libre de opioides: ¿un cambio de paradigma?]]></article-title>
<source><![CDATA[Revista Española de Anestesiología y Reanimación]]></source>
<year>2017</year>
<volume>64</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>427-30</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Connolly]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Buggy]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Opioids and tumour metastasis: does the choice of the anesthetic-analgesic technique influence outcome after cancer surgery?]]></article-title>
<source><![CDATA[Curr Opin Anesthesiol]]></source>
<year>2016</year>
<volume>29</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>468-74</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boysen]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
<name>
<surname><![CDATA[Pappas]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain]]></article-title>
<source><![CDATA[Ochsner J]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fierro Díaz]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Vanegas Mendieta]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Beltrán Gallegos]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia, analgesia, reumatología y alivio del dolor agudo y crónico]]></article-title>
<source><![CDATA[Rev Cuba Reumatol]]></source>
<year>2019</year>
<volume>21</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>56</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Naranjo-González]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anestesia libre de opioides en cirugía ambulatoria]]></article-title>
<source><![CDATA[Rev Mex Anestesiolog]]></source>
<year>2015</year>
<volume>38</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>156-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mefkur]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Tarik]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Ufuk]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Harun]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Mehmet]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study]]></article-title>
<source><![CDATA[Braz J Anesth]]></source>
<year>2015</year>
<volume>65</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>191-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lavand homme]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Estebe]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Opioid-free anesthesia: a different regard to anesthesia practice]]></article-title>
<source><![CDATA[Rev. Anest]]></source>
<year>2018</year>
<volume>31</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vincent]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bernald]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Leonel]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Farmacología de los anestésicos locales]]></article-title>
<source><![CDATA[Rev Anest y Reanimac]]></source>
<year>2019</year>
<volume>45</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-19</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hameurlaine]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kock]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Should opioid free anesthesia be integrated in enhanced recovery protocols?]]></article-title>
<source><![CDATA[Acta Anaesth. Belg]]></source>
<year>2018</year>
<volume>69</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>77-83</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
