2024, Número 08
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Ginecol Obstet Mex 2024; 92 (08)
Complicaciones anestésicas en pacientes con preeclampsia con criterios de severidad
Marisancén CK, Villegas AJD, Martínez SLM, Durango SC, Saavedra VME, Vera MC, Jaramillo JLI
Idioma: Español
Referencias bibliográficas: 39
Paginas: 315-325
Archivo PDF: 208.77 Kb.
RESUMEN
Objetivo: Describir las complicaciones anestésicas en pacientes con preeclampsia
con criterios de severidad.
Materiales y Métodos: Estudio observacional, retrospectivo, transversal y descriptivo
llevado a cabo en un centro de atención terciaria de la ciudad de Medellín,
Colombia, entre enero de 2016 y enero de 2021. La fuente de información fueron las
historias clínicas.
Criterios de inclusión: pacientes embarazadas, con preeclampsia
con criterios de severidad que recibieron anestesia neuroaxial o general. Criterios de
exclusión: pacientes con diagnóstico previo de coagulopatías y con otros trastornos
hipertensivos del embarazo no relacionados con la preeclampsia con características
graves. Se hizo un muestreo no probabilístico de casos consecutivos y un análisis
univariado.
Resultados: Se incluyeron 508 pacientes; el 69% finalizaron el embarazo mediante
cesárea. El 89.4% recibió anestesia neuroaxial y el 10.6% anestesia general. El 29.9%
ingresó a cuidados intensivos, 4.7% tuvo hipotensión, 3.9% requirió soporte vasopresor,
3.7% con vía aérea difícil, 0.98% requirió ventilación mecánica. Una paciente resultó
con edema pulmonar y otra con accidente cerebrovascular hemorrágico. El 1.5% de
quienes recibieron anestesia espinal tuvo retención urinaria. La frecuencia de anestesia
neuroaxial fallida fue del 1.4% para parto y 1.3% para cesárea. No se registraron casos
de muerte, meningitis, aracnoiditis, paraplejia, punción de la duramadre accidental
o reacción alérgica.
Conclusiones: La anestesia neuroaxial sigue siendo la técnica anestésica de elección
en pacientes con preeclampsia con criterios de severidad. Las complicaciones
anestésicas evidenciadas con más frecuencia fueron el ingreso a cuidados intensivos,
hipotensión y requerimiento de soporte vasopresor.
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