<?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>0034-7531</journal-id>
<journal-title><![CDATA[Revista Cubana de Pediatría]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Pediatr]]></abbrev-journal-title>
<issn>0034-7531</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-75312020000200015</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Analgesia multimodal una alternativa para el paciente quirúrgico]]></article-title>
<article-title xml:lang="en"><![CDATA[Multimodal analgesia: an alternative for the surgical patient]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soto Otero]]></surname>
<given-names><![CDATA[Yaime]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro de Cirugía de Mínimo Acceso  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>92</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-75312020000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-75312020000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-75312020000200015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El dolor posterior a una intervención quirúrgica, es un síntoma frecuentemente observado, no cumple una función útil y el peligro de no tratarlo aumenta la morbilidad y mortalidad posoperatoria.  Objetivo:  Destacar la importancia de la analgesia multimodal en el control del dolor agudo posoperatorio.  Métodos:  Revisión en la literatura impresa tanto nacional como internacional, sobre la analgesia y la modalidad multimodal y además, se hizo búsqueda en Internet. En los artículos revisados se obtuvieron distintos aspectos clínicos de la analgesia multimodal y de sus protocolos.  Resultados:  En la actualidad para mitigar el dolor y alcanzar la máxima expresión en la analgesia posoperatoria se han desarrollado diferentes modalidades analgésicas, aunque de todas ellas solo ha alcanzado mayor grado de recomendación, la analgesia multimodal porque es capaz de conseguir con su efecto sinérgico y con pequeñas dosis, una mejor potencia para producir analgesia y menos efectos adversos.  Consideraciones finales:  La analgesia multimodal logra un control adecuado del dolor agudo posoperatorio, disminuye las complicaciones posoperatorias y la necesidad de analgesia de rescate, pero todo esto depende del protocolo de analgesia multimodal propuesto, la vía de administración de los fármacos elegidos, sus dosis y el cumplimiento de los intervalos de aplicación.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The pain after surgery is a frequently observed symptom, it is not a useful function and the danger of not treating it increases postoperative morbidity and mortality.  Objective:  To highlight the importance of multimodal analgesia in the control of acute postoperative pain.  Methods:  It was made a review in the printed literature both national and international on the multimodal analgesia, and in addition, a search in Internet. In the reviewed articles there were obtained different clinical aspects of multimodal analgesia and its protocolization.  Results:  Nowadays, in order to mitigate the pain and achieve the maximum expression in the postoperative analgesia, there have been developed different analgesic modalities, although of all of them it only has achieved a greater degree of recommendation, the multimodal analgesia because it is capable of achieving with its synergetic effect and with small doses, a better power to produce analgesia and fewer adverse effects.  Conclusions:  The multimodal analgesia achieved adequate control of acute postoperative pain, decreasing the inherent complications of this state and the need of rescue analgesia. All of the above depends on the proposed protocol of multimodal analgesia, the route of administration of the chosen drugs, their doses and the compliance of the application intervals.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[dolor]]></kwd>
<kwd lng="es"><![CDATA[analgesia posoperatoria]]></kwd>
<kwd lng="es"><![CDATA[analgesia multimodal]]></kwd>
<kwd lng="en"><![CDATA[pain]]></kwd>
<kwd lng="en"><![CDATA[postoperative analgesia]]></kwd>
<kwd lng="en"><![CDATA[multimodal analgesia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sérgio]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Mozart]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Máximo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Vanius]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Analgesia pós-operatória multimodal em cirurgia ginecológica videolaparoscópica ambulatorial: comparação entre parecoxib e tenoxicam]]></article-title>
<source><![CDATA[Rev Bras Anestesiol]]></source>
<year>2005</year>
<volume>55</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>158-64</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[de la Gala]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dolor postoperatorio: analgesia multimodal]]></article-title>
<source><![CDATA[Rev Locomotor]]></source>
<year>2004</year>
<volume>2</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>176-88</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[Vasallo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Arjona]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Analgesia multimodal posoperatoria en cirugía ginecológica y obstétrica urgente]]></article-title>
<source><![CDATA[Rev Cubana Nestesiol Reanim]]></source>
<year>2011</year>
<volume>10</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>205-12</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[López]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Argente]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendaciones prácticas para el tratamiento del dolor agudo postoperatorio mediante técnicas analgésicas continuas Valencia]]></article-title>
<source><![CDATA[Publicaciones Ámbito]]></source>
<year>2013</year>
<volume>7</volume>
<page-range>13-29</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marret]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kurdi]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Zufferey]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnet]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of non steroidal antiinflammatory drug son patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials]]></article-title>
<source><![CDATA[Anesthesiogy]]></source>
<year>2005</year>
<volume>102</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1249-60</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[Kehlet]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Holte]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of postoperative analgesia on surgical outcome]]></article-title>
<source><![CDATA[Br J Anaesth]]></source>
<year>2001</year>
<volume>87</volume>
<page-range>62-72</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[Kehlet]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of postoperative pain treatment on outcome-current status and future strategies]]></article-title>
<source><![CDATA[Arch Surg]]></source>
<year>2004</year>
<volume>389</volume>
<page-range>244-9</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[Gallardo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El dolor postoperatorio pasado, presente, y futuro]]></article-title>
<source><![CDATA[Rev Chil Anestesiol]]></source>
<year>2010</year>
<volume>39</volume>
<page-range>69-75</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manual de dolor agudo postoperatorio]]></article-title>
<source><![CDATA[Rev Anestesiología]]></source>
<year>2010</year>
<volume>5</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>9-11</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[G Jr]]></given-names>
</name>
</person-group>
<source><![CDATA[Anestesiología clínica]]></source>
<year>2014</year>
<edition>4ta</edition>
<publisher-loc><![CDATA[Mexico ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Manual Moderno]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Navarrete-Zuazo]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz-Mendiondo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aspectos básicos del dolor postoperatorio y la analgesia multimodal preventiva]]></article-title>
<source><![CDATA[Rev Mex Anestesiol]]></source>
<year>2014</year>
<volume>37</volume>
<page-range>18-26</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[Fletcher]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anesthésie- Réanimation. Conférences d'actualisation]]></article-title>
<source><![CDATA[Rev Bras Anestesiol]]></source>
<year>1996</year>
<page-range>8-171</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[Fletcher]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Negre]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Barbin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[François]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carreres]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Falgueirette]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Postoperative analgesia with IV propacetamol and ketoprofen combination after disc surgery]]></article-title>
<source><![CDATA[Can J Anaesth]]></source>
<year>1997</year>
<volume>44</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>85-479</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[Kehlet]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Werner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Perkins]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Balanced analgesia: what is it and what are its advantages in postoperative period?]]></article-title>
<source><![CDATA[Drugs]]></source>
<year>1999</year>
<volume>58</volume>
<page-range>793-7</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Woolf]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pain: moving from symptom control towards mechanism-specific pharmacologic management]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>2004</year>
<volume>140</volume>
<page-range>441-51</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Girish]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Joshi]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Farcsi]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Técnicas de analgesia multimodal y de rehabilitación postoperatoria]]></article-title>
<source><![CDATA[Rev Anestesiol]]></source>
<year>2005</year>
<volume>23</volume>
<page-range>185-202</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bujedo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Bizueta]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Garde]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estrategias para el abordaje multimodal del dolor y de la recuperación postoperatoria]]></article-title>
<source><![CDATA[Rev Esp Anestesiologia Reanimaciòn]]></source>
<year>2007</year>
<volume>54</volume>
<page-range>29-40</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Analgesia multimodal postoperatoria]]></article-title>
<source><![CDATA[Rev Soc Esp Dolor]]></source>
<year>2005</year>
<volume>12</volume>
<page-range>112-8</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
