<?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>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032025000300248</article-id>
<article-id pub-id-type="doi">10.35366/119951</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Identificación del uso de rescates analgésicos para control de dolor en pacientes obstétricas posterior al uso de morfina subaracnoidea]]></article-title>
<article-title xml:lang="en"><![CDATA[Identification of the use of analgesic rescue for pain control in obstetric patients after the use of subarachnoid morphine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chávez Duarte]]></surname>
<given-names><![CDATA[Jacqueline]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aranzazú Pérez Penilla]]></surname>
<given-names><![CDATA[Martha]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rendón Morales]]></surname>
<given-names><![CDATA[Alejandro Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Berrón Pérez]]></surname>
<given-names><![CDATA[Santiago Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Castillo]]></surname>
<given-names><![CDATA[María Guadalupe Graciela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez Riveroll]]></surname>
<given-names><![CDATA[Karla Iztel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Fosado]]></surname>
<given-names><![CDATA[Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad La Salle México Facultad Mexicana de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Nuevo Sanatorio Durango  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<volume>23</volume>
<numero>3</numero>
<fpage>248</fpage>
<lpage>253</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032025000300248&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032025000300248&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032025000300248&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La cesárea a menudo conlleva dolor postoperatorio significativo, mitigado efectivamente por la analgesia multimodal, incluyendo el uso de morfina intratecal.  Objetivo:  Explorar el manejo del dolor postquirúrgico en pacientes sometidas a cesárea, evaluando si las variaciones en las dosis de morfina impactan en el uso de tramadol adicional, más allá del tratamiento estándar con analgésicos antiinflamatorios no-esteroideos.  Material y métodos:  Se realizó un estudio descriptivo y observacional sobre manejo de dolor postcesárea, incluyendo mujeres de 18-39 años, clasificadas como ASA II y III, utilizando anestesia neuroaxial y analgesia basada en AINE.  Resultados:  Este estudio revisó 165 expedientes de pacientes de cesárea, eligiendo 50 de 16 a 39 años, mayormente sanas y primerizas, que recibieron manejo de dolor postoperatorio con morfina intratecal y AINE, evidenciando una efectiva mitigación del dolor.  Conclusión:  La morfina intratecal y la analgesia multimodal adaptada individualmente es eficaz. Las limitaciones incluyen su naturaleza retrospectiva y el tamaño de muestra, con oportunidades para explorar alternativas de morfina que reduzcan costos y contaminación, y consideraciones adicionales en pacientes que lactan y ya no tienen acceso a opioides de amplio espectro. Sin embargo, estas estrategias han demostrado mejorar el confort materno y reducir la estancia hospitalaria.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Cesarean section often involves significant postoperative pain, which is effectively mitigated by multimodal analgesia, including the use of intrathecal morphine.  Objective:  To explore post-surgical pain management in patients undergoing cesarean section, assessing whether variations in morphine dosages significantly impact the additional use of tramadol beyond the standard treatment with nonsteroidal anti-inflammatory drugs (NSAIDs).  Material and methods:  An analytical and observational study on post-cesarean pain management was conducted, including women aged 18-39, classified as ASA II and III, using neuro-axial anesthesia and NSAID-based analgesia.  Results:  This study reviewed 165 cesarean patient records, selecting 50 between the ages of 16 and 39, predominantly healthy and first-time mothers, who received postoperative pain management with intrathecal morphine and NSAIDs, demonstrating effective pain mitigation.  Conclusion:  Intrathecal morphine and individually tailored multimodal analgesia are effective. Limitations include its retrospective nature and sample size, with opportunities to explore morphine alternatives that could reduce costs and environmental pollution, and additional considerations for breastfeeding patients who no longer have access to broad-spectrum opioids. Nonetheless, these strategies have improved maternal comfort and reduced hospital stays.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="es"><![CDATA[dolor postoperatorio]]></kwd>
<kwd lng="es"><![CDATA[morfina]]></kwd>
<kwd lng="es"><![CDATA[analgesia multimodal]]></kwd>
<kwd lng="es"><![CDATA[tramadol]]></kwd>
<kwd lng="en"><![CDATA[cesarean section]]></kwd>
<kwd lng="en"><![CDATA[postoperative pain]]></kwd>
<kwd lng="en"><![CDATA[morphine]]></kwd>
<kwd lng="en"><![CDATA[multimodal analgesia]]></kwd>
<kwd lng="en"><![CDATA[tramadol]]></kwd>
</kwd-group>
</article-meta>
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