Visita pre-anestésica como factor predictor de riesgo perioperatorio y post-operatorio en cirugías electivas del quirófano central. Hospital IESS Dr. Teodoro Maldonado Carbo
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedente: La evaluación preanestésica tiene como ventajas la reducción de la morbilidad y un aumento de la calidad del procedimiento quirúrgico-anestésico. Cuando se realiza antes de la fecha de la cirugía, promueve una reducción de la ansiedad del paciente, la cancelación de cirugías y los costos debido a exámenes auxiliares y consultas de subespecialidad solicitados en el período preoperatorio.
Objetivo: Evaluar la visita pre-anestésica como factor predictor de riesgo perioperatorio y post-operatorio en cirugías electivas del Hospital Regional IESS Dr. Teodoro Maldonado Carbo.
Metodología: Estudio de tipo analítico, de diseño no experimental, transversal y retrospectivo. Se analizó 100 registros médicos de pacientes que fueron intervenidas quirúrgicamente por diversas etiologías en el quirófano central del Hospital Regional IESS Dr. Teodoro Maldonado Carbo en el periodo del 1 de marzo del 2016 hasta 28 de febrero del 2017.
Resultados: El 58% de los pacientes analizados estuvo representado por el sexo masculino y el 42% por el sexo femenino. El grupo etario de mayor proporción fue el de > 60 años con el 39%. El promedio de edad fue de 53,19 años. El 54% correspondió al grupo con IMC entre 25-29,99 kg/m2, que corresponde al de Preobesidad. Se encontraron 6 casos de Diabetes Mellitus, 38 casos de hipertensión arterial, 11 casos de DM+HTA y 6 casos de arritmias cardíacas. El factor de riesgo más frecuente en la muestra de pacientes analizados fue el antecedente de cirugía previa con el 64%. El 73% (73) correspondió al grupo II de la clasificación de Mallampati. La distancia interdentaria (apertura de la boca) promedio fue de 3,23 cm. La anestesia raquídea fue la más utilizada (49%). Se observó un 10% de eventos adversos intraoperatorios y un 2% de eventos adversos postoperatorios. Se suspendieron 11 intervenciones quirúrgicas (11%), siendo la principal causa de suspensión la crisis hipertensivas (6%). El 52% (52) correspondió al grupo II de la clasificación de la American Society of Anesthesiologists, mientras que en segundo lugar de frecuencia estuvo el grupo III con el 39% y el riesgo quirúrgico se dividió en: Alto (29%), Intermedio (67%) y Bajo (4%).
Conclusión: Se concluye que la visita preanestésica es un pilar fundamental en el riesgo quirúrgico de los pacientes, ya que detecta factores de riesgo, comorbilidades y alteraciones en la vía aérea que puedan dificultar el procedimiento anestésico subsecuente.
Background: Pre-anesthetic evaluation has the advantages of reducing morbidity and increasing the quality of the surgical-anesthetic procedure. When performed prior to the date of surgery, it promotes a reduction in patient anxiety, cancellation of surgeries and costs due to ancillary exams and subspecialty consultations requested in the preoperative period. Objective: To evaluate the pre-anesthetic visit as a predictor of peri-operative and postoperative risk in elective surgeries at the IESS Regional Hospital Dr. Teodoro Maldonado Carbo. Methodology: A analitic, non-experimental, transverse and retrospective study. We analyzed 100 medical records of patients who underwent surgery for various etiologies in the central operating room of the IESS Regional Hospital Dr. Teodoro Maldonado Carbo in the period from March 1, 2016 to February 28, 2017. Results: Fifty-eight percent of the patients analyzed were male and 42% female. The highest age group was> 60 years old with 39%. The mean age was 53.19 years. 54% corresponded to the group with BMI between 25-29.99 kg / m2, corresponding to Preobesity. We found 6 cases of diabetes mellitus, 38 cases of hypertension, 11 cases of DM + hypertension and 6 cases of cardiac arrhythmias. The most frequent risk factor in the sample of patients analyzed was the history of previous surgery with 64%. 73% (73) corresponded to group II of the Mallampati classification. The average interdental distance (opening of the mouth) was 3.23 cm. Spinal anesthesia was the most used (49%). 10% of intraoperative adverse events and 2% of postoperative adverse events were observed. Eleven surgical interventions were suspended (11%), being the main cause of suspension the hypertensive crisis (6%). Fifty-two percent (52) were in the American Society of Anesthesiologists classification group II, while the second group was group III with 39% and the surgical risk was divided into: High (29%), Intermediate (67%) and Low (4%). Conclusion: It is concluded that the preanesthetic visit is a fundamental pillar in the surgical risk of patients, since it detects risk factors, comorbidities and alterations in the airway that may hinder the subsequent anesthetic procedure.
Background: Pre-anesthetic evaluation has the advantages of reducing morbidity and increasing the quality of the surgical-anesthetic procedure. When performed prior to the date of surgery, it promotes a reduction in patient anxiety, cancellation of surgeries and costs due to ancillary exams and subspecialty consultations requested in the preoperative period. Objective: To evaluate the pre-anesthetic visit as a predictor of peri-operative and postoperative risk in elective surgeries at the IESS Regional Hospital Dr. Teodoro Maldonado Carbo. Methodology: A analitic, non-experimental, transverse and retrospective study. We analyzed 100 medical records of patients who underwent surgery for various etiologies in the central operating room of the IESS Regional Hospital Dr. Teodoro Maldonado Carbo in the period from March 1, 2016 to February 28, 2017. Results: Fifty-eight percent of the patients analyzed were male and 42% female. The highest age group was> 60 years old with 39%. The mean age was 53.19 years. 54% corresponded to the group with BMI between 25-29.99 kg / m2, corresponding to Preobesity. We found 6 cases of diabetes mellitus, 38 cases of hypertension, 11 cases of DM + hypertension and 6 cases of cardiac arrhythmias. The most frequent risk factor in the sample of patients analyzed was the history of previous surgery with 64%. 73% (73) corresponded to group II of the Mallampati classification. The average interdental distance (opening of the mouth) was 3.23 cm. Spinal anesthesia was the most used (49%). 10% of intraoperative adverse events and 2% of postoperative adverse events were observed. Eleven surgical interventions were suspended (11%), being the main cause of suspension the hypertensive crisis (6%). Fifty-two percent (52) were in the American Society of Anesthesiologists classification group II, while the second group was group III with 39% and the surgical risk was divided into: High (29%), Intermediate (67%) and Low (4%). Conclusion: It is concluded that the preanesthetic visit is a fundamental pillar in the surgical risk of patients, since it detects risk factors, comorbidities and alterations in the airway that may hinder the subsequent anesthetic procedure.
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Valoración preanestésica, Cirugía, Epidemiología analítica, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador