Fernández WR, Correa PJM, Labrada DA, Tamargo BTO

Language: Spanish
References: 18
Page: 72-83
PDF size: 327.85 Kb.

ABSTRACT

Introduction. The regional anesthesia by using the combination of the technical epidural and subarachnoidea achieves a quick start-up of the anesthetic blockade with the possibility to extend this one by means of the extradural encore of dose of local anesthetics through a peridural catheter. Methods. It was realized a descriptive, longitudinal investigation in a total of 100 patients ASA I and II programmed for elective surgery in “General Calixto García” Hospital in the period April 2008–May 2009. Combined spinal epidural anesthesia was applied fulfilling the inclusion criteria. Results. There was a physiological descent in the systolic, diastolic and mean arterial blood pressure just as heart rate, being but marked at 5 minutes after the beginning of the procedure for after keep stable all parameters. The main immediate complications occurred was bradycardia (52 %) and low arterial blood pressure (11 %). The back pain was the mediate complication but frequently opposing (20 %). Conclusions. By considering the stable hemodynamic conduct and the low incidence of complications, we recommended for abdominal hysterectomy, the combined spinal epidural anesthesia as a good procedure of regional anesthesia.

REFERENCES

1. Soresi AL. Episubdural Anesthesia. Anesth Analg 2007;16:306 – 310.

2. Nagashima N. Combined spinal-epidural anesthesia for intra-abdominal gynecological surgeries. Masui 2006;45(9):1153-59.

3. Waegerle JD. Combined spinal-epidural. Anesth Analg 2000;10(4):155-64.

4. Aguilar S. Perforación de la duramadre con catéter peridural: caso clínico. Revista Venezolana de anestesiología 2002;7(1):46-9.

5. Whizar L. Migración subaracnoidea del catéter o del anestésico durante anestesia epidural-espinal combinada. Informe de caso. Rev Anest Mex 2004;20(2):91-5.

6. Holmstrom B, Ramal N, Axelsson K. Risk of catheter migration dured combined subarachnoid peridural block – percutaneus epiduroscopy study. Anesth Analg 2005;80:747-53.

7. Suzuki N, Koganemaru M, Onizuka S. Dural puncture with a 26 G spinal needle affects epidural anaesthesia. Anesth Analg 1996;82(5):1040-2.

8. Camann W. Alleged problems with combined spinal and epidural anesthesia. Regional Anesthesia Pain Medicine 2000;25(1):104-5.

9. Puolakka R, Pitknen MT, Rosenberg PH. Comparison of the technical and block characteristics of different spinal and epidural anaesthesia techniques. Reg Anesth Pain Med 2001;26(1):17-23.

10. Rawal N, Schollin J, Wesstrom G. Epidural versus spinal epidural block for Caesarean section. Acta Anaesthesiol Scand 1988;32(1):61-6.

11. Scott DB, McClure JH, Giasi RM. Effects of concentration of local anesthetic drugs in extradural block. Br J Anaesth 1989;52(10):1033-7.

12. Barash P, Cullen B, Stoelting R. Anestesia epidural y raquídea. En: Harry F, Bacon D, editores. Manual de anesthesia clínica. Mexico: McGraw – Hill; 2005.p.371–5.

13. Obando T. Bloqueo combinado versus bloqueo epidural y subaranoideo en cirugías de cadera y miembros inferiores Nicaragua. Rev Anest Mex 2006;15(2):3-5.

14. Kety SS, King BD, Horvath SM. The effects of an acute reduction in blood pressure by means of differencial spinal sympathetic block on the cerebral circulation of hypertensive patiens. J Clin Invest 2006;29(4); 403-7.

15. Braunwald E, Zipes DP. Heart disease, 6th ed. WB Saunders and Company 2007;p. 300-23.

16. Lindh A, Andersson AS, Westman L. Is transient lumbar pain after spinal anaesthesia with lidocaine influenced by early mobilisation? Acta Anaesthesiol Scand 2001;45(3):290-93.

17. CooK TM. Combined spinal epidural techniques. Anesthesia 2000;55(1):42-64.

18. Puolakka R, Pitknen MT, Rosenberg PH. Technical aspects and postoperativessequelae of spinal and epidural anesthesia: A prospectiven study of 3230 orthopedic patients. Reg Anesth Pain Med 2000;25(5):488-97.