HIPOTENSION ARTERIAL Y NIVEL ANESTÉSICO DE ACUERDO A LA VELOCIDAD DE INYECCIÓN DE LA ANESTESIA ESPINAL EN PACIENTES SOMETIDAS A OPERACIÓN CESÁREA
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Rev. Méd. La Paz
Abstract
Objetivo: Determinar si una disminución de la velocidad de inyección del anestésico local durante una anestesia espinal brinda un nivel anestésico adecuado para realizar una operación cesárea con menor incidencia de hipotensión arterial. Metodología: Se realizó un estudio de cohortes, prospectivo que incluyó 108 gestantes a término programadas para cesárea electiva y de urgencia y uso de bloqueo espinal en condiciones similares, quedando 54 participantes en el grupo de infusión LENTO (30-60 segundos) y 54 en el grupo RAPIDO (15-30 segundos). Resultados: No se encontraron diferencias entre ambos grupos en las variables demográficas analizadas, nivel anestésico, presión arterial sistólica basal, bienestar fetal (APGAR), líquidos intravenosos administrados y pérdida hemática transoperatoria. Se evidenció una mayor frecuencia de hipotensión arterial en las pacientes del Grupo RAPIDO (68.50%) en comparación con las del Grupo LENTO (38.80%). De la misma forma se evidenció una mayor aparición de eventos adversos, secundarios a la hipotensión arterial, como náuseas y vómitos en las pacientes del Grupo RAPIDO. Se encontró cierta similitud en el grado de satisfacción entre las pacientes de ambos grupos. Conclusión: La velocidad de inyección lenta del anestésico podría reducir la importancia de la hipotensión inducida por anestesia espinal para cesárea, sin modificar la extensión bloqueo sensorial cefálico o nivel anestésico.
Objective: To determine whether a decrease in the injection speed of local anesthetic during spinal anesthesia provides an adequate anesthetic level to perform a cesarean section with a lower incidence of arterial hypotension. Methodology: A prospective cohort study was carried out. It considered 108 full- term pregnant women scheduled for elective and emergency cesarean section as well as use of spinal block under similar conditions, corresponding 54 patients in the SLOW infusion group (30-60 seconds) and 54 in the FAST group (15-30 seconds). Results: No differences were found between both groups regarding the demographics, anesthetic level, baseline systolic blood pressure, fetal well-being (Apgar), administered intravenous fluids and intraoperative blood loss. A higher frequency of arterial hypotension was observed in patients of the FAST Group (68.50%) compared to those in the SLOW Group (38.80%). Likewise, a greater occurrence of adverse effects secondary to arterial hypotension, such as nausea and vomiting, was evident in those of the FAST Group. A certain similarity in the degree of satisfaction among patients of both groups was found. Conclusion: Slow injection speed of the anesthetic could reduce the hypotension induced by spinal anesthesia for cesarean section, without modifying the extent of cephalic sensory block or anesthetic level.
Objective: To determine whether a decrease in the injection speed of local anesthetic during spinal anesthesia provides an adequate anesthetic level to perform a cesarean section with a lower incidence of arterial hypotension. Methodology: A prospective cohort study was carried out. It considered 108 full- term pregnant women scheduled for elective and emergency cesarean section as well as use of spinal block under similar conditions, corresponding 54 patients in the SLOW infusion group (30-60 seconds) and 54 in the FAST group (15-30 seconds). Results: No differences were found between both groups regarding the demographics, anesthetic level, baseline systolic blood pressure, fetal well-being (Apgar), administered intravenous fluids and intraoperative blood loss. A higher frequency of arterial hypotension was observed in patients of the FAST Group (68.50%) compared to those in the SLOW Group (38.80%). Likewise, a greater occurrence of adverse effects secondary to arterial hypotension, such as nausea and vomiting, was evident in those of the FAST Group. A certain similarity in the degree of satisfaction among patients of both groups was found. Conclusion: Slow injection speed of the anesthetic could reduce the hypotension induced by spinal anesthesia for cesarean section, without modifying the extent of cephalic sensory block or anesthetic level.
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Vol. 30, No. 2