
ResumenObjetivoAnalizar la frecuencia de cefalea pospunción de la duramadre (CPPD) y el tratamiento más utilizado para esta complicación anestésica en los quirófanos centrales del Hospital General de México.MétodoEstudio retrospectivo, transversal, observacional y descriptivo. Se revisaron las hojas de anestesia de mujeres y hombres, con técnica anestésica de bloqueo epidural y punción accidental de la duramadre. Se analizó la presentación de cefalea pospunción dural y el tratamiento más frecuente. Se estudiaron las variables: Sexo, edad, peso, talla, índice de masa corporal, localización e intensidad de cefalea y tratamiento. El análisis estadístico se llevó a cabo con medias, desviación estándar y rangos para variables cuantitativas, frecuencias y porcentajes para variables cualitativas, y prueba de t de Student pareada.ResultadosSe revisaron 2,114 registros anestésicos, hubo punción accidental de la duramadre en 58 sujetos, y en 14 (0.66%) se presentó CPPD, 10 (71.4%) en el sexo femenino y 4 (28.6%) en el masculino. La cefalea se localizó con mayor frecuencia en la región frontal (85.7%). Se administró tratamiento conservador en 58 sujetos. Se administraron líquidos en el 100%, reposo en decúbito dorsal en 57 (9.2%) y analgésicos en 55 (94.8%). Se aplicó parche hemático epidural profiláctico en 12 pacientes, y fue efectivo en 9 (15.5%) casos, con una media de sangre autóloga de 16.5±4.8. La relación entre CPPD y escala visual análoga antes y después del tratamiento con medidas conservadoras e invasivas obtuvo una media de 4.1±3.06, con un IC al 95% (2.37-5.91) y una p=0.0001.ConclusionesLa CPPD es una complicación frecuente, de predominio en el sexo femenino, en la quinta década de la vida. El tratamiento conservador y el parche hemático epidural profiláctico previenen la aparición de cefalea.AbstractObjectiveFrequency of post-dural puncture headache (PDPH) and most common treatment for this complication were analyzed in the central operating rooms of the Hospital General de México.MethodsA retrospective, transversal, observational and descriptive study. Anesthesia records of men and women with epidural anesthetic technique and accidental dural puncture were reviewed. Presentation of post-dural puncture headache and most common treatment were analyzed. Age, sex, weight, height, body mass index, location, intensity, and treatment of headache, were studied. Statistical analysis was performed using means, standard deviations and ranges for quantitative variables, frequencies and percentages to qualitative variables and Student t test paired.Results2,114 anesthetic records were reviewed, in 58 subjects occurred accidental dural puncture, PDPH in 14 (0.66%), 10 (71.4%) in female and 4 (28.6%) in male. Headache was located more frequently in the frontal region (85.7%). Conservative treatment was administered to 58 subjects, fluids were administered at 100%, rest in the supine position in 57 (9.2%) and analgesics in 55 (94.8%). Prophylactic epidural blood patch was performed in 12 patients and was effective in 9 (15.5%) cases, with a mean of 16.5±4.8 autologous blood. Relationship between PDPH and analogue visual scale before and after conservative and invasive treatment scored a mean of 4.1±3.06 with a 95% CI (2.37-5.91) and P=.0001.ConclusionsPDPH is a common complication, predominantly in women in the fifth decade of life. Conservative treatment and prophylactic epidural blood patch prevent the onset of headache.
Blood patch, Medicine (General), R5-920, Punción accidental de duramadre, Parche hemático, Headache, Cefalea, Epidural block, Bloqueo epidural, Accidental dural puncture
Blood patch, Medicine (General), R5-920, Punción accidental de duramadre, Parche hemático, Headache, Cefalea, Epidural block, Bloqueo epidural, Accidental dural puncture
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