Year 2021 / Volume 28 / Number 4

Abstract PDF HTML

Cilinical Note

Treatment by ultrasound-guided neurolysis with 6 % aqueous phenol of the pain component for post-amputation neuromas: report of a clinical case

Rev. Soc. Esp. Dolor. 2021; 28(4): 239-241 / DOI: 10.20986/resed.2021.3928/2021

Paula Arauzo, Rocío Periñán, María Arnaudas, Sofía Bes, Jordi Recasens, Sergi Boada


ABSTRACT

Introduction: Magement of pain caused by neuromas is in itself complex. The treatment options once the surgical route has been ruled out are few, although the impact that this pain produces in the lives of patients makes it necessary to look for alternative cases that offer acceptable control of it.
The objective is to present neurolysis as an effective alternative for pain due to neuromas.
Case report: Descriptive and retrospective case report of a patient belonging to the National Health System, carried out by the Pain Unit of the Anesthesiology and Resuscitation Service of the Hospital Universitario Joan XXIII.
59-year-old patient who, after refusing surgery, underwent ultrasound-guided neurolysis with 6 % aqueous phenol for the treatment of pain due to neuromas derived from the amputation of both upper limbs.
Discusion: Infiltration with 6 % aqueous phenol can considerably reduce pain, for a time equal to or greater than 6 months, granting a significant improvement in the quality of life of patients.



RESUMEN

Introducción: El tratamiento del dolor producido por neuromas es en sí complejo. Las opciones de tratamiento una vez se ha descartado la vía quirúrgica son pocas, si bien el impacto que dicho dolor produce en la vida de los pacientes obliga a buscar en estos casos alternativas que ofrezcan un control aceptable del mismo.
El objetivo es presentar la neurólisis como una alternativa eficaz para el dolor por neuromas.
Caso clínico: Reporte de caso, descriptivo y retrospectivo, de paciente perteneciente al Sistema Nacional de Salud, llevado a cabo por la Unidad de Dolor del Servicio de Anestesiología y Reanimación del Hospital Universitario Joan XXIII.
Paciente de 59 años a quien, tras rechazar la cirugía, se le realizó neurólisis ecoguiada con fenol al 6 % acuososo para el tratamiento del dolor por neuromas derivados de la amputación de ambos miembros superiores.
Discusión: La infiltración con fenol 6 % acuoso puede llegar a disminuir considerablemente el dolor durante un tiempo igual o superior a los 6 meses, otorgando una mejoría significativa en la calidad de vida de los pacientes.





Complete Article

Nuevo comentario

Security code:
CAPTCHA code image
Speak the codeChange the code
 

Comentarios

No comments in this article

Bibliografía

1. Adams MCB, Benzon HT, Hurley RW. Practical Management of Pain. Elsevier: Mosby; 2014. p. 784-93.
2. Gruber H, Kovacs P, Peer S, Frishchhut S, Bodner G. Sonographically guided phenol injection in painful stump neuroma. AJR Am J Roentgenol. 2004;182(4):952-4.
DOI: 10.2214/ajr.182.4.1820952
3. Curatolo M, Eichenberger U. Techniques in Regional Anesthesia and Pain Management. Elsevier; 2007. p. 95-102.
DOI: 10.1053/j.trap.2007.02.012
4. Magnan B, Samaila E, Schirru L, Maluta T, Luppi V, Valentini R. Phenol injection for Morton's neuroma under elettroneurographic guidance. Foot Ankle Surg. 2017;23(S1):23-5.
DOI: 10.1016/j.fas.2017.07.1115

Artículos relacionados

Continuous electrical stimulation for the treatment of trigeminal neuralgia. A systematic review

Rev. Soc. Esp. Dolor. 2023; 30(4): 217-226 / DOI: 10.20986/resed.2023.4043/2022

Problems and adverse reactions related to dipyrone in Colombia

Rev. Soc. Esp. Dolor. 2023; 30(4): 210-216 / DOI: 10.20986/resed.2023.4025/2022

Ultrasound-guided ankle nerve block as adjuvant therapy in chronic pain after occupational injury.

Rev. Soc. Esp. Dolor. 2023; 30(3): 178-186 / DOI: 10.20986/resed.2023.4035/2022

Pharmacogenetics in analgesic response: towards a sex-differences personalized medicine

Rev. Soc. Esp. Dolor. 2023; 30(2): 115-124 / DOI: 10.20986/resed.2023.4042/2022

Effect of therapeutic exercise in persons with sacroiliac joint dysfunction: a systematic review and meta-analysis

Rev. Soc. Esp. Dolor. 2023; 30(2): 95-108 / DOI: 10.20986/resed.2023.4034/2022

Effects of transcranial direct current stimulation in pain and opioid consumption after spine surgery

Rev. Soc. Esp. Dolor. 2023; 30(1): 49-59 / DOI: 10.1002/ejp.1985

Effectiveness of cluneal nerve block for the treatment of chronic low back pain

Rev. Soc. Esp. Dolor. 2023; 30(1): 30-35 / DOI: 10.20986/resed.2023.4023/2022

Review of the remission and management of a cancer related pain population to a pain unit. What can we improve?

Rev. Soc. Esp. Dolor. 2023; 30(1): 7-14 / DOI: 10.20986/resed.2023.4010/2022

Effectiveness of electroacupuncture and moxibustion in the treatment of postoperative anterior cruciate ligament graft pain with meniscal remodeling. Case study UNEVT 2022

Rev. Soc. Esp. Dolor. 2022; 29(3): 192-195 / DOI: 10.20986/resed.2022.4009/2022

Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults

Rev. Soc. Esp. Dolor. 2022; 29(3): 175-186 / DOI: 10.1002/ejp.1975

Usefulness of percutaneous basivertebral nerve thermorizotomy for the treatment of chronic low back pain. Literature review

Rev. Soc. Esp. Dolor. 2022; 29(3): 169-174 / DOI: 10.20986/resed.2022.4044/2022

Efficacy of physiotherapy on the anxiety and depression in patients with chronic pain: a systematic review

Rev. Soc. Esp. Dolor. 2022; 29(3): 157-168 / DOI: 10.20986/resed.2022.3994/2022

Psychological intervention program to promoted active coping in patients with chronic back pain

Rev. Soc. Esp. Dolor. 2022; 29(3): 149-156 / DOI: 10.20986/resed.2022.3993/2022

Effects of hydrotherapy on pain in osteoarthritis and fibromyalgia: a narrative review

Rev. Soc. Esp. Dolor. 2022; 29(2): 78-87 / DOI: 10.20986/resed.2022.3955/2021

Practical aspects of product selection and titration with medical cannabis for chronic pain management

Rev. Soc. Esp. Dolor. 2022; 29(13): 43-51 / DOI: 10.20986/resed.2022.4031/2022

Medical cannabis treatment in patients with visceral chronic pain

Rev. Soc. Esp. Dolor. 2022; 29(13): 32-42 / DOI: 10.20986/resed.2022.4030/2022

Current evidence of medical cannabis treatment in patients with chronic pain

Rev. Soc. Esp. Dolor. 2022; 29(13): 10-13 / DOI: 10.20986/resed.2022.4024/2022

Some preclinical results of cannabinoids and pain

Rev. Soc. Esp. Dolor. 2022; 29(13): 3-9 / DOI: 10.20986/resed.2022.4033/2022

Use of 8 % capsaicin patches for the treatment of lumbar neuropathic pain

Rev. Soc. Esp. Dolor. 2022; 29(1): 28-33 / DOI: 10.20986/resed.2022.3995/2022

Ultrasound guided interlaminar epidural steroid injection: the cumulative sum method (CUSUM) for performance evaluation

Rev. Soc. Esp. Dolor. 2022; 29(1): 21-27 / DOI: 10.20986/resed.2022.3988/2022

Peroneal neuropathy caused by an extraneural ganglion: literary review and treatment proposal. A non-positive case

Rev. Soc. Esp. Dolor. 2021; 28(6): 354-357 / DOI: 10.20986/resed.2022.3919/2021

Use of botulinum toxin for pain after amputation

Rev. Soc. Esp. Dolor. 2021; 28(6): 332-342 / DOI: 10.20986/resed.2022.3943/2021

Lumbar epidural steroids injections reduce catastrophism on the lumbosacral radicular syndrome

Rev. Soc. Esp. Dolor. 2021; 28(6): 325-331 / DOI: 10.20986/resed.2022.3947/2021

Preliminary study on the evaluation of mechanical pressure pain and central pain modulation mechanisms by algometry in an anesthesia unit

Rev. Soc. Esp. Dolor. 2021; 28(6): 311-318 / DOI: 10.20986/resed.2022.3885/2021

New opioids with different intracellular mechanism of action; is a new therapeutic window opening up?

Rev. Soc. Esp. Dolor. 2021; 28(5): 292-297 / DOI: 10.20986/resed.2021.3891/2021

Efficacy and complications of analgesic techniques for the treatment of moderate to severe postoperative acute pain

Rev. Soc. Esp. Dolor. 2021; 28(5): 264-265 / DOI: 10.20986/resed.2021.3942/2021

Descriptive study on the profile of patients sent to the Chronic Pain Treatment Unit of the University Hospital of Gran Canaria Dr. Negrín (UTDC-HUGCDN) as a basis for the reorganization of this

Rev. Soc. Esp. Dolor. 2021; 28(5): 254-263 / DOI: 10.20986/resed.2021.3939/2021

Dorsal root ganlion pulsed radiofrequency for lumbosacral radicular pain: a narrative review

Rev. Soc. Esp. Dolor. 2021; 28(4): 219-231 / DOI: 10.20986/resed.2021.3882/2021

Observational and prospective study on the effectiveness and safety of the dorsal root ganglion stimulation in patients with refractory neuropathic pain

Rev. Soc. Esp. Dolor. 2021; 28(2): 148-156 / DOI: 10.20986/resed.2021.3879/2020

Epidemiological profile of pain secondary to moderate diabetic peripheral neuropathy

Rev. Soc. Esp. Dolor. 2021; 28(2): 129-136 / DOI: 10.20986/resed.2021.3826/2020

Botulinum toxin for the treatment of myofascial pain syndrome

Rev. Soc. Esp. Dolor. 2021; 28(2): 100-110 / DOI: 10.20986/resed.2021.3902/2021

Risk of misuse of prescribed opioids in patients with chronic noncancer pain in a workers compensation system hospital in Chile

Rev. Soc. Esp. Dolor. 2021; 28(2): 82-91 / DOI: 10.20986/resed.2021.3845/2020

Evolution of low back pain in cancer patients treated with interventional pain management

Rev. Soc. Esp. Dolor. 2021; 28(2): 76-81 / DOI: 10.20986/resed.2021.3901/2021

Analgesic effectiveness of tapentadol in neuropathic pain secondary to post-laminectomy syndrome

Rev. Soc. Esp. Dolor. 2021; 28(2): 71-75 / DOI: 10.20986/resed.2021.3822/2020

Parsonage-turner after rabies vaccination due to bat bite: case report

Rev. Soc. Esp. Dolor. 2021; 28(1): 57-61 / DOI: 10.20986/resed.2021.3832/2020

Inflammatory mediators: its connection with chronic pain and associated problems. Review

Rev. Soc. Esp. Dolor. 2021; 28(1): 37-46 / DOI: 10.20986/resed.2021.3841/2020

Management and perception of therapeutic adherence of breakthrough cancer pain by oncologists in Spain

Rev. Soc. Esp. Dolor. 2021; 28(1): 19-26 / DOI: 10.20986/resed.2021.3824/2020

Implementation and evaluation of a multimodal analgesia protocol for total knee arthroplasty including ultrasoundguided adductor canal block and periarticular local anesthetic infiltration

Rev. Soc. Esp. Dolor. 2021; 28(1): 9-18 / DOI: 10.20986/resed.2021.3847/2020

Interventional management of osteoarthritic pain

Rev. Soc. Esp. Dolor. 2021; 28(13): 85-90 / DOI: 10.20986/resed.2021.3853/2020

New pharmacological targets for osteoarthritis induced pain

Rev. Soc. Esp. Dolor. 2021; 28(13): 57-63 / DOI: 10.20986/resed.2021.3863/2020

Opioids in osteoarthritis

Rev. Soc. Esp. Dolor. 2021; 28(13): 49-56 / DOI: 10.20986/resed.2021.3855/2020

Central sensitization in osteoarthritis

Rev. Soc. Esp. Dolor. 2021; 28(13): 31-37 / DOI: 10.20986/resed.2021.3876/2020

Experimental models for pain evaluation in osteoarthritis

Rev. Soc. Esp. Dolor. 2021; 28(13): 18-30 / DOI: 10.20986/resed.2021.3872/2020

Epidemiology, clinical impact and therapeutic objectives in osteoarthritis

Rev. Soc. Esp. Dolor. 2021; 28(13): 4-10 / DOI: 10.20986/resed.2021.3874/2020

Adaptation of the chronic pain unit of the Hospital Complex from Vigo to the state of alarm due to the SARS-CoV-2 pandemic

Rev. Soc. Esp. Dolor. 2020; 27(6): 392-393 / DOI: 10.20986/resed.2020.3827/2020

Transitional pain clinic

Rev. Soc. Esp. Dolor. 2020; 27(6): 369-374 / DOI: 10.20986/resed.2020.3840/2020

Study of pain in rehabilitation treatments

Rev. Soc. Esp. Dolor. 2020; 27(6): 361-368 / DOI: 10.20986/resed.2020.3809/2020

Opioid misuse in patients with cancer pain: an integrative systematic review of the literature

Rev. Soc. Esp. Dolor. 2020; 27(5): 306-315 / DOI: 10.20986/resed.2020.3801/2020

Identification of signs and symptoms for the diagnosis of discogenic low back pain: mapping review

Rev. Soc. Esp. Dolor. 2020; 27(5): 292-297 / DOI: 10.20986/resed.2020.3803/2020

Efficacy of lidocaine perfusions in fibromyalgia: a prospective cohort study

Rev. Soc. Esp. Dolor. 2020; 27(5): 287-291 / DOI: 10.20986/resed.2020.3796/2020

Splanchnic nerve block for the treatment of benign chronic abdominal pain. a case report and literature review

Rev. Soc. Esp. Dolor. 2020; 27(4): 273-277 / DOI: 10.20986/resed.2020.3818/2020

Clinical pathophysiology in patients with sickle cell disease: the transition from acute to chronic pain

Rev. Soc. Esp. Dolor. 2020; 27(4): 257-268 / DOI: 10.20986/resed.2020.3814/2020

Gender determinants in the approach to chronic pain

Rev. Soc. Esp. Dolor. 2020; 27(4): 252-256 / DOI: 10.20986/resed.2020.3802/2020

Incidence of postmastectomy pain syndrome. Retrospective analysis

Rev. Soc. Esp. Dolor. 2020; 27(4): 246-251 / DOI: 10.20986/resed.2020.3797/2020

Sociodemographic and clinical characterization in patients with chronic back pain, Cienfuegos 2019

Rev. Soc. Esp. Dolor. 2020; 27(4): 239-245 / DOI: 10.20986/resed.2020.3798/2020

Management of breakthrough pain associated with the cure of skin ulcers

Rev. Soc. Esp. Dolor. 2020; 27(2): 113-126 / DOI: 10.20986/resed.2020.3755/2019

Ethical problems in the management of pain. Qualitative study through open reflection interview

Rev. Soc. Esp. Dolor. 2020; 27(2): 89-96 / DOI: 10.20986/resed.2020.3729/2019

Review of the impact of acupuncture treatment on the management of nonspecific low back pain

Rev. Soc. Esp. Dolor. 2020; 27(1): 53-58 / DOI: 10.20986/resed.2020.3762/2019

Effectiveness of the association of lacosamide in trigeminal neuralgia

Rev. Soc. Esp. Dolor. 2020; 27(1): 50-52 / DOI: 10.20986/resed.2019.3738/2019

Efficacy of pregabalin, gabapentin and duloxetine in neuropathic pain verified by the p-curve analysis

Rev. Soc. Esp. Dolor. 2020; 27(1): 16-23 / DOI: 10.20986/resed.2020.3727/2019

Neurolytic procedures for pancreatic cáncer pain: a systematic review and a proposal for an algorithm treatment

Rev. Soc. Esp. Dolor. 2019; 26(6): 342-358 / DOI: 10.20986/resed.2019.3715/2018

Valuation of the relationship between the rotational restriction of high cervical column and high thoracic column in students with and without cervical pain of the Faculty of Sciences of the Rehabilitation

Rev. Soc. Esp. Dolor. 2019; 26(6): 337-341 / DOI: 10.20986/resed.2019.3698/2018

Correlation study between diagnostic opportunity and pain severity in patients with fibromyalgia who enter the Nononcological Chronic Pain Unit at the San Borja Arriarán Clinical Hospital

Rev. Soc. Esp. Dolor. 2019; 26(6): 331-336 / DOI: 10.20986/resed.2019.3690/2018

Connexins in chronic pain. A new target?

Rev. Soc. Esp. Dolor. 2019; 26(6): 322-323 / DOI: 10.20986/resed.2019.3785/2019

Applicability of scales/indicators for pain monitoring in critically ill patients incapable of verbalizing: a systematic review of the literature

Rev. Soc. Esp. Dolor. 2019; 26(5): 293-303 / DOI: 10.20986/resed.2019.3726/2019

Validation of the coping strategies to chronic pain reduced questionnaire in the cienfuegan population with chronic back pain (2017-2018)

Rev. Soc. Esp. Dolor. 2019; 26(5): 276-283 / DOI: 10.20986/resed.2019.3732/2019

New strategies for postoperative pain control in tonsillectomy surgery. Is all that glitters gold?

Rev. Soc. Esp. Dolor. 2019; 26(5): 270-275 / DOI: 10.20986/resed.2019.3742/2019

The use of new technologies in patients with chronic pain. A reality that cannot be denied

Rev. Soc. Esp. Dolor. 2019; 26(5): 259-260 / DOI: 10.20986/resed.2019.3766/2019

Orofacial pain in the dental clinic

Rev. Soc. Esp. Dolor. 2019; 26(4): 233-242 / DOI: 10.20986/resed.2019.3724/2019

Role of depressive symptomatology, catastrophism and expectation in the efficacy of interventional treatment in chronic low back pain

Rev. Soc. Esp. Dolor. 2019; 26(4): 227-232 / DOI: 10.20986/resed.2019.3704/2018

The new international classification of diseases (ICD-11) and chronic pain. Pragmatical implications

Rev. Soc. Esp. Dolor. 2019; 26(4): 209-210 / DOI: 10.20986/resed.2019.3752/2019

Optimization of postoperative pain management based on a new technological tool. Pain map

Rev. Soc. Esp. Dolor. 2019; 26(3): 154-165 / DOI: 10.20986/resed.2019.3696/2018

Sublingual fentanyl for the treatment of breakthrough cancer pain during allergic reactions to chemotherapy infusion

Rev. Soc. Esp. Dolor. 2019; 26(3): 148-153 / DOI: 10.20986/resed.2018.3689/2018

Pulsed radiofrequency treatment in the neuropathy of the pudendal nerve: report of a case

Rev. Soc. Esp. Dolor. 2019; 26(2): 128-129 / DOI: 10.20986/resed.2016.3517/2016

Motor block after caudal epidural infiltration: a case report

Rev. Soc. Esp. Dolor. 2019; 26(2): 120-123 / DOI: 10.20986/resed.2018.3669/2018

Myofascial pain syndrome as a cause of postoperative acute pain in hip surgery

Rev. Soc. Esp. Dolor. 2019; 26(2): 117-119 / DOI: 10.20986/resed.2019.3655/2018

Dry needling and changes in muscular activity in subjects with myphastial trigger points: case series

Rev. Soc. Esp. Dolor. 2019; 26(2): 89-94 / DOI: 10.20986/resed.2018.3677/2018

Effectiveness of hand crossing to produce analgesia in patients with chronic pain of the upper limb

Rev. Soc. Esp. Dolor. 2019; 26(2): 81-88 / DOI: 10.20986/resed.2019.3674/2018

Profiles of personality and resilience in chronic pain: utility of the CDRISC-10 to discriminate between resilient and vulnerable types

Rev. Soc. Esp. Dolor. 2019; 26(2): 72-80 / DOI: 10.20986/resed.2018.3670/2018

Oxytocin and chronic pain in humans

Rev. Soc. Esp. Dolor. 2019; 26(1): 52-58 / DOI: 10.20986/resed.2018.3664/2018

ACNES as a cause of chronic abdominal pain

Rev. Soc. Esp. Dolor. 2018; 25(6): 360-361 / DOI: 10.20986/resed.2017.3530/2016

Dysphonia as side-effect dose-dependent during treatment with duloxetine

Rev. Soc. Esp. Dolor. 2018; 25(6): 359-359 / DOI: 10.20986/resed.2017.3528/2016

Evidence-based recommendations for the management of neuropathic pain (review of the literature)

Rev. Soc. Esp. Dolor. 2018; 25(6): 349-358 / DOI: 10.20986/resed.2018.3673/2018

Use of major opioids for control of pain in hospitalized patients

Rev. Soc. Esp. Dolor. 2018; 25(6): 318-324 / DOI: 10.20986/resed.2018.3629/2017

Implications of bioethics in the treatment of chronic pain: the change of paradigms

Rev. Soc. Esp. Dolor. 2018; 25(5): 291-300 / DOI: 10.20986/resed.2018.3666/2018

Experience in two hospitals about the observation of pain responses in hospitalized preterm infants

Rev. Soc. Esp. Dolor. 2018; 25(5): 271-277 / DOI: 10.20986/resed.2018.3633/2017

Platelet-rich plasma in treating peripheral neuropathic pain. Preliminary report

Rev. Soc. Esp. Dolor. 2018; 25(5): 263-270 / DOI: 10.20986/resed.2017.3625/2017

Chrono study: prevalence of breakthrough pain among patients with non-cancer chronic pain in Andalusia, Spain

Rev Soc Esp Dolor 2018; 25(4): 214-221 / DOI: 10.20986/resed.2017.3626/2017

Trial therapy on laterality and motor imagery and selective glenohumeral muscle activation in patients with massive rotator cuff tear: case series

Rev Soc Esp Dolor 2018; 25(4): 197-206 / DOI: 10.20986/resed.2017.3610/2017

Pharmacological management of acute postoperative pain in Spain. Data from the national survey by the Spanish Pain Society (SED)

Rev Soc Esp Dolor 2018; 25(2): 70-85 / DOI: 10.20986/resed.2017.3593/2017

Potential uses of Mirtazapine in palliative care beyond its antidepressant effect

Rev Soc Esp Dolor 2018; 25(1): 37-44 / DOI: 10.20986/resed.2017.3575/2017

Prevalence of pain in patients hospitalized in Metabolic Intensive Care Units with orotracheal intubation and under sedation, measured with the COMFORT scale

Rev Soc Esp Dolor 2018; 25(1): 7-12 / DOI: 10.20986/resed.2017.3581/2017

Chronic pain: relationship with prefrontal symptoms and perceived stress

Rev Soc Esp Dolor 2017; 24(4): 179-187 / DOI: 10.20986/resed.2017.3540/2016

Prevalence of breakthrough pain associated with chronic low back pain in Andalusia (COLUMBUS study)

Rev Soc Esp Dolor 2017; 24(3):116-124 / DOI: 10.20986/resed.2017.3548/2016

Prescribing strong opioids in patients with non-cancer pain: a description of their characteristics in an area of primary healthcare assistance

Rev Soc Esp Dolor 2017; 24(1): 19-26 / DOI: 10.20986/resed.2016.3471/2016

Factors associated with pain intensity in Mexican patients hospitalized in postoperative period

Rev Soc Esp Dolor 2017; 24(1): 4-10 / DOI: 10.20986/resed.2016.3442/2016

Instrucciones para citar

Arauzo P, Periñán R, Arnaudas M, Bes S, Recasens J, Boada S, et all. Treatment by ultrasound-guided neurolysis with 6 % aqueous phenol of the pain component for post-amputation neuromas: report of a clinical case. Rev Soc Esp Dolor 2021; 28(4): 239-241 / DOI: 1020986/resed20213928/2021


Descargar a un gestores de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica

Este artículo ha sido visitado 20916 veces.
Este artículo ha sido descargado 1 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 23/05/2021

Aceptado: 20/08/2021

Prepublicado: 27/08/2021

Publicado: 15/10/2021

Tiempo de revisión del artículo: 20 días

Tiempo de prepublicación: 96 días

Tiempo de edición del artículo: 145 días


Compartir

Este artículo aun no tiene valoraciones.
Reader rating:
Rate this article:
Send by e-mail
© 2024 Revista de la Sociedad Española del Dolor
ISSN: 1134-8046   e-ISSN: 2254-6189

       Indexada en:
Política de Privacidad