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Colombian Journal of Anesthesiology
Article . 2014 . Peer-reviewed
License: CC BY NC ND
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Colombian Journal of Anesthesiology
Article . 2014
License: CC BY NC ND
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Incidencia de complicaciones neurológicas y cefalea pospunción dural luego de anestesia regional en la práctica obstétrica: un estudio retrospectivo de 2399 pacientes

Authors: Domingos Dias, Cicarelli; Frerichs, Elke; Martins Benseñor, Fábio Ely;

Incidencia de complicaciones neurológicas y cefalea pospunción dural luego de anestesia regional en la práctica obstétrica: un estudio retrospectivo de 2399 pacientes

Abstract

ResumenIntroducción y objetivosLa anestesia regional brinda una excelente anestesia y analgesia en pacientes obstétricas, pero existe el potencial de complicaciones tales como la cefalea pospunción dural y lesión neurológica permanente o transitoria. El presente estudio pretende describir la incidencia de la cefalea pospunción dural y daño neurológico en la población obstétrica de un hospital universitario que fue tratada con bloqueo neuroaxial, en comparación con la literatura mundial e identificar los factores de riesgo.Material y métodosSe hizo una cohorte retrospectiva incluyendo los datos recolectados a partir de los registros de consultas posanestesia durante el año 2010. El análisis central se hizo en función de las quejas de déficit neurológico periférico y cefaleas reportadas por los pacientes, el tipo de anestesia y el procedimiento quirúrgico realizado. Se aplicó un análisis de regresión múltiple para investigar la relación entre el inicio de parestesias de las extremidades inferiores y el tiempo en que permanecieron estas pacientes en posición ginecológica y otras variables.ResultadosSe evaluaron en total 2399 pacientes embarazadas tratadas con bloqueo neuroaxial. Las complicaciones neurológicas que se presentaron en estas pacientes se dividieron en parestesias de las extremidades inferiores (0,3%), irritación radicular transitoria (0,1%) y cefalea pospunción dural (3%). Las pacientes que permanecieron más de 60min en posición ginecológica mostraron un índice de probabilidades (odds ratio) de evolución con parestesia de las extremidades inferiores de 1,75, y las pacientes que estuvieron más de 120min mostraron un índice de probabilidades de 2,1, pero sin significación estadística.ConclusionesLas pacientes que se sometieron a bloqueo neuroaxial y se colocaron en posición ginecológica tenían mayores probabilidades de evolucionar con parestesias de las extremidades inferiores por el tiempo que permanecieron en esta posición.AbstractIntroduction and objectivesRegional anesthesia provides excellent anesthesia and analgesia in obstetric patients, but has potential for complications such as post-dural puncture headache and permanent or transient nerve damage. This study aimed to describe the incidence of post-dural puncture headache and nerve damage in the obstetric population of auniversity hospital that was submitted to neuraxial blockades, comparing with the world literature, and identify risk factors.Materials and methodsA retrospective cohort was performed including data collected in the records of post-anesthetic consults conducted during the year 2010. The main analysis was performed on the complaints of peripheral neurological deficits and headaches reported by patients, type of anesthesia and performed surgical procedures. A multiple regression analysis was performed to investigate the association between the onset of lower limb paresthesias and the length of stay of these patients in the gynecological position and other variables.ResultsA total of 2399 pregnant patients who had undergone neuraxial blockade were evaluated. Neurologic complications that occurred in these patients were divided into lower limb paresthesias (0.3%), transient radicular irritation (0.1%), and post-dural puncture headache (3%). The patients who stayed more than 60 min in gynecological position showed an odds ratio of evolution with lower limb paresthesias of 1.75 and patients who stayed more than 120 min showed an odds ratio of 2.1, but without statistical significance.ConclusionsPatients submitted to neuraxial blockades and placed in gynecological position were more likely to evolve with lower limb paresthesias related to duration of this position.

Keywords

Anesthesia, Epidural, Obstetrical Anesthesia, Conduction Analgesia, Nerve Block, Critical Care and Intensive Care Medicine, Anestesia de conducción, Bloqueo nervioso, Anesthesiology and Pain Medicine, Anestesia obstétrica, Anesthesia, Conduction, Epidural, Anesthesia, Obstetrical, Anesthesia, Anestesia epidural, Analgesia

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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!
3
Average
Average
Average
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