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2010, Número 4

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Rev Mex Anest 2010; 33 (4)


Síndrome de cauda equina y aracnoiditis a partir de una dosis epidural de cloroprocaína inyectada por vía subdural: El adiós a un anestésico local

Aldrete JA, Godinez-Cubillo N, Ramirez-Bermejo A, Ghaly RF

Idioma: Ingles.
Referencias bibliográficas: 46
Paginas: 220-224
Archivo PDF: 377.84 Kb.


RESUMEN

La cloroprocaína (ClPr) ha atravesado por controversias en relación con su bajo pH, con los conservantes y con los antioxidantes. En una paciente parturienta que había dado a luz recientemente, y que se encontraba programada para tener una ligadura de trompas postparto, usando el mismo catéter utilizado en el trabajo de parto, la aspiración fue negativa. La dosis de prueba con el anestésico falló para indicar la inyección intratecal o intravascular; y el hecho de que ocurriera una demora, condujo a dosis adicionales. Luego de que se hubieron suministrado 15 mL, se observó hipotensión y bloqueo sensorial a T5. Se suministraron 10 mL más alcanzando un nivel C5 luego de que se hubiera completado una dosis de 25 mL. El lento establecimiento aconsejó el empleo de una inyección peridural (epidural); subsiguientemente, la paciente desarrolló cauda equina y aracnoiditis, lo que sugiere que la dosis planeada para la anestesia peridural eventualmente ingresó al espacio intratecal.


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