Incidencia de cefalea post-punción raquídea con aguja espinal Spinocan no. 27 y no. 25 en pacientes cesareadas Hospital Regional 2 del IESS Dr. Teodoro Maldonado Carbo año 2012-2013
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2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La anestesia raquídea para la cesárea es una técnica efectiva por sus ventajas sobre el bloqueo epidural que incluye ausencia de riesgo de toxicidad sistemática en la madre y en el feto porque se necesita menor cantidad de anestésico local, la técnica es fácil, rapidez en el inicio de la anestesia y muchos anestesiólogos creen que la calidad de la anestesia es mejor y que hay menos disconfort en la tracción del útero. El objetivo es conocer la incidencia de cefalea post anestesia epidural en pacientes sometidas a cesárea, utilizando la aguja Spinocan Nº 25 y 27, en el Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” 2013. La investigación fue tipo descriptiva. Ensayo clínico controlado simple ciego. Diseño de la investigación: Prospectivo- no experimental. Se estudiarán 128 pacientes asignados en dos grupos: el A y B Los datos que se obtuvieron fueron introducidos en el programa EPI INFO 3.5.1 2008. Resultados: Se presentaron fallos en la instauración de la anestesia raquídea en el 1,56% (dos pinchazos) y 0% de problemas en el mantenimiento. Del grupo de pacientes desarrollan CPPD se resolvió con tratamiento conservador. En las pacientes de este estudio ninguna necesito de tratamiento de parche hemático. La anestesia raquídea hace que esta técnica siga considerándose el estándar de la analgesia obstétrica, sin embargo, no está exenta de riesgos, siendo los más graves los neurológicos.
Spinal anesthesia for cesarean section is an effective approach given its advantages over the epidural block, including lower or very rare maternal, systemic or fetal toxicity risk due to the smaller local anesthetic doses needed for this kind of anesthesia, this technique is also easier, faster and many anesthesiologists think that the quality of the spinal anesthesia is better and that the displeasure felt by the patient is much lesser in the moment of uterus traction . The main purpose in this study is getting to know the incidence of Post Dural puncture headache in patients who underwent cesarean section and spinal anesthesia using two different sizes (25 an 27 G) of spinocan ® spinal needles in the Ob/Gy service of Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” during part of 2012 and 2013 years. This research was descriptive. Simple blind controlled clinical assay , the kind of investigation was non experimental prospective. 128 patients were divided into two groups (A-B). Results and data obtained were included in the EPI INFO 3.5.1 2008 software. Results: Spinal anesthesia failure were present in two patients (1.56%) so double puncture had to be performed, maintenance of anesthesia was uneventful . The patients who developed PDP headache responded very well to conservative treatment. None of the patients in this study needed a blood patch. For all its advantages Spinal anesthesia keeps being considered the standard in obstetrics anesthesia nevertheless its not totally free of risk being the most intimidating the neurologic complications .
Spinal anesthesia for cesarean section is an effective approach given its advantages over the epidural block, including lower or very rare maternal, systemic or fetal toxicity risk due to the smaller local anesthetic doses needed for this kind of anesthesia, this technique is also easier, faster and many anesthesiologists think that the quality of the spinal anesthesia is better and that the displeasure felt by the patient is much lesser in the moment of uterus traction . The main purpose in this study is getting to know the incidence of Post Dural puncture headache in patients who underwent cesarean section and spinal anesthesia using two different sizes (25 an 27 G) of spinocan ® spinal needles in the Ob/Gy service of Hospital Regional 2 IESS “Dr. Teodoro Maldonado Carbo” during part of 2012 and 2013 years. This research was descriptive. Simple blind controlled clinical assay , the kind of investigation was non experimental prospective. 128 patients were divided into two groups (A-B). Results and data obtained were included in the EPI INFO 3.5.1 2008 software. Results: Spinal anesthesia failure were present in two patients (1.56%) so double puncture had to be performed, maintenance of anesthesia was uneventful . The patients who developed PDP headache responded very well to conservative treatment. None of the patients in this study needed a blood patch. For all its advantages Spinal anesthesia keeps being considered the standard in obstetrics anesthesia nevertheless its not totally free of risk being the most intimidating the neurologic complications .
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Anestesia raquídea, Cesárea, Punción, Aguja espinal Spinocan, Cefalea, Epidemiología descriptiva, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Cefalea pospunción raquídea