Falla o resistencia en la anestesia espinal para cesárea / Failure or resistance in spinal anesthesia for cesarean section
Rev. cuba. anestesiol. reanim
; 17(3): 1-7, set.-dic. 2018. ilus
Article
em Es
| CUMED, LILACS
| ID: biblio-991037
Biblioteca responsável:
CU1.1
RESUMEN
Introducción:
La anestesia regional es la más empleada en la cesárea obstétrica. En particular, el uso de la anestesia intratecal tiene sus ventajas. Aunque la tasa de falla es baja, la aparición de este evento genera dificultades que merecen atención.Objetivo:
Describir la conducta anestésica en una paciente obstétrica en la que falla la anestesia regional intratecal. Caso clínico Paciente femenina, de 20 años a la que se le administró anestesia intratecal por el especialista. No hubo errores en la punción lumbar, esta se realizó con trócar 25 punta Whitacre. No se constató bloqueo sensitivo, motor ni simpático, por lo que se realizó anestesia general endotraqueal, la cual transcurrió sin dificultades. En el posoperatorio inmediato se observa hiperlaxitud articular lo que llevó a sospechar el diagnóstico. Este fue positivo conjuntamente con el servicio de Neurología, se determinó Síndrome de Ehlers danlos tipo III.Conclusiones:
El índice de falla es muy bajo en anestesia suaracnoidea pero si se presenta un paciente de este tipo, debe descartarse por completo. Existen pocos casos documentados de resistencia a la anestesia local; pero si así fuera, debe estudiarse exhaustivamente para buscar estrategias que permitan un acto anestésico óptimo(AU)ABSTRACT
Introduction:
Regional anesthesia is the most used in obstetric caesarean section. In particular, the use of intrathecal anesthesia has its advantages. Although the failure rate is low, the onset of this event generates difficulties that deserve attention.Objective:
To describe the anesthetic management in an obstetric patient with failure of regional intrathecal anesthesia. Clinical case Female patient, aged 20 years, who was administered intrathecal anesthesia by the specialist. There were no errors in the lumbar puncture, this was done with a trocar 25 of Whitacre tip. No sensory, motor or sympathetic block was observed, so general endotracheal anesthesia was performed, which went on smoothly. In the immediate postoperative period, joint hypermobility was observed, leading to suspicion of the diagnosis. This was positive in conjunction with the Neurology service, Ehlers-Danlos syndrome type 3 was determined.Conclusions:
The failure rate is very low for subarachnoid anesthesia. However, for a patient of this type, it should be completely ruled out. There are few documented cases of resistance to local anesthesia. If it were the case, it should be studied exhaustively to look for strategies that allow an optimal anesthetic management(AU)Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
CUMED
/
LILACS
Assunto principal:
Resistência a Medicamentos
/
Cesárea
/
Raquianestesia
Limite:
Female
/
Humans
Idioma:
Es
Revista:
Rev. cuba. anestesiol. reanim
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Cuba
País de publicação:
Cuba