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Incidencia de Hipotensión Materna durante la anestesia regional subaracnoidea para cirugía cesarea

Authors: Chaparro Espinosa, Rodrigo Aturo;

Incidencia de Hipotensión Materna durante la anestesia regional subaracnoidea para cirugía cesarea

Abstract

La cesárea es la cirugía más frecuentemente realizada a nivel mundial, llegando en muchos lugares a superar las cifras recomendadas por la OMS de 15% de los nacimientos y en Colombia superan el 30 %, según los datos más recientes de las encuestas de Demografía y salud publicada en 2010(1)(2) . La Anestesia Subaracnoidea (Asa) es la principal técnica anestésica utilizada para esta cirugía, hasta el 87 y 90 % en el Reino Unido y Estados Unidos respectivamente(3)(4). La hipotensión arterial es la principal complicación de la anestesia subaracnoidea, con una incidencia que oscila entre el 40 y 100% de los casos(5)(6). Objetivo: Conocer la incidencia de hipotensión materna en la cirugía cesárea bajo anestesia regional subaracnoidea en el Hospital Universitario Clínica San Rafael en la población materna descrita sometida a cirugía cesárea electiva o de urgencia. Materiales y Métodos: Se realizó un estudio Observacional retrospectivo con componente analítico, donde se evaluó el impacto de las intervenciones llevadas a cabo por el anestesiólogo para contrarrestar la Hipotensión Materna bajo esta técnica. Resultados: Nuestra incidencia de Hipotensión materna durante éste procedimiento, es muy similar a la reportada en la literatura internacional 73%; en una población con características antropométricas concordantes con incremento del riesgo de hipotensión descritas; la técnica para contrarrestar la hipotensión más empleada es la cocarga de líquidos 53,5% de los casos. Conclusiones: Nuestra incidencia de hipotensión materna es alta, 73%; a pesar de emplear cocarga de líquidos, como estrategia principal para contrarrestarla, 69,8%; el sub-registro impide ver el impacto de otras estrategias. Caesarean section is the most frequently surgery performed worldwide. Subarachnoid Anesthesia (ASA) is the main anesthetic technique used for this surgery, to 87 and 90% in the UK and the USA respectively. Hypotension is the main complication of spinal anesthesia, with an incidence ranging between 40 and 100% of cases. Objectives: To determine the incidence of maternal hypotension during elective or emergency Cesarean section at the Hospital Universitario Clínica San Rafael. Materials and Methods: It was made a retrospective observational study with an analytical component, where the impact of interventions conducted by the anesthesiologist to counteract Maternal hypotension under this technique was evaluated. Results: Our incidence of maternal hypotension during this procedure is very similar to that reported in the international literature 73%; in a population with anthropometric characteristics consistent with increased risk of hypotension described; the technique used to counteract the hypotension is the fluids coload, 53.5% of cases. Conclusions: Our incidence of maternal hypotension is high, despite using fluids coload 69.8%, as the main strategy to counteract it; underreporting does not allow evaluate the imppsct of the other strategies.

Country
Colombia
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Keywords

hypotension, low- dose spinal anesthesia, Vasopresor, Cocarga, ANESTESIA EPIDURAL, CESAREA (OPERACION), caeserea section, vasopressor, Anestesia espinal, coload, Hipotensión, Bajas dosis de anestesia regional, HIPOTENSION EN EL EMBARAZO, preload, Precarga, ANESTESIA REGIONAL, Cesárea, spinal anesthesia

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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