Monitoreo transoperatorio de la fracción espirada de dióxido de carbono en el paciente sometido a cirugía traumatológica bajo anestesia espinal
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El presente estudio tiene como finalidad demostrar que para el anestesiólogo es importante conocer y analizar la concentración transoperatoria de la fracción espirada final de dióxido de carbono (FEFCO2) en el paciente sometido a cirugía traumatológica bajo anestesia espinal. El trabajo de investigación se realizó en el Hospital Clínica Kennedy, mediante el registro capnográfico, para disminuir las alteraciones en el equilibrio ácido-base durante el transoperatorio y sus repercusiones en el postoperatorio. Mediante vigilancia continua de la FEFCO2 fue posible obtener un registro capnográfico para poder corregir las alteraciones hemodinámicas que en ocasiones no corresponden a las manifestaciones presentadas durante el transoperatorio. Se estudiaron 85 pacientes entre el período 2014 – 2016, sometidos a cirugía traumatológica bajo anestesia espinal con y sin sedación consciente, se aplica monitoreo fisiológico, monitorización del índice biespectral (BIS) y se coloca el dispositivo para medir la FEFCO2 durante el procedimiento quirúrgico. La utilización del capnógrafo nasal para realizar el estudio, toma la muestra de CO2 directamente de las narinas del paciente, asociado a la administración suplementaria de oxígeno (O2), hace que la muestra sea confiable. Se visualizó un incremento en el valor de la FEFCO2 a los 15, 30 y 60 minutos en los pacientes bajo anestesia espinal con sedación consciente. Con todo esto, podemos determinar que el monitoreo de la FEFCO2 puede ser aplicado durante el periodo transoperatorio en este tipo de procedimientos, sin causar riesgos para el paciente.
This study aims to demonstrate that it is important for the anesthesiologist know and analyze the concentration transoperatory end fractional exhaled carbon dioxide (FEFCO2) in patients undergoing orthopedic surgery under spinal anesthesia. The research was conducted at the Kennedy Clinic Hospital, by capnográfico registration, to reduce disturbances in the acid -base balance during surgery and its impact on postoperative. Through continuous monitoring of the FEFCO2 it was possible to get a record capnográfico to correct the hemodynamic alterations that sometimes do not correspond to the statements submitted during surgery. Were studied 85 patients between the period 2014- 2016, undergoing orthopedic surgery under spinal anesthesia with or without conscious sedation, physiological monitoring , monitoring of the bispectral index (BIS) is applied and the device is placed to measure the FEFCO2 during the surgical procedure. The use of nasal capnography for the study, take the sample of CO2 directly from the nostrils of the patient, associated with the administration of supplemental oxygen (O2), it causes the sample is reliable. An increase in the value of FEFCO2 at 15, 30 and 60 minutes in patients under spinal anesthesia with sedation is visualized. With all this, we can determine that FEFCO2 monitoring can be applied during the perioperative period in this type of procedures, without causing risks to the patient
This study aims to demonstrate that it is important for the anesthesiologist know and analyze the concentration transoperatory end fractional exhaled carbon dioxide (FEFCO2) in patients undergoing orthopedic surgery under spinal anesthesia. The research was conducted at the Kennedy Clinic Hospital, by capnográfico registration, to reduce disturbances in the acid -base balance during surgery and its impact on postoperative. Through continuous monitoring of the FEFCO2 it was possible to get a record capnográfico to correct the hemodynamic alterations that sometimes do not correspond to the statements submitted during surgery. Were studied 85 patients between the period 2014- 2016, undergoing orthopedic surgery under spinal anesthesia with or without conscious sedation, physiological monitoring , monitoring of the bispectral index (BIS) is applied and the device is placed to measure the FEFCO2 during the surgical procedure. The use of nasal capnography for the study, take the sample of CO2 directly from the nostrils of the patient, associated with the administration of supplemental oxygen (O2), it causes the sample is reliable. An increase in the value of FEFCO2 at 15, 30 and 60 minutes in patients under spinal anesthesia with sedation is visualized. With all this, we can determine that FEFCO2 monitoring can be applied during the perioperative period in this type of procedures, without causing risks to the patient
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Monitoreo fisiológico, Anestesia raquidea, Dióxido de carbono, Cirugía, Traumatología, Hospital Clínica Kennedy, Cantón Guayaquil, Ecuador