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2011, Número 4

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Rev Mex Anest 2011; 34 (4)


Paraplejía después de cirugía de aorta infrarrenal con anestesia epidural y general

Ramírez-Guerrero JA, Corona-Cedillo R

Idioma: Español
Referencias bibliográficas: 37
Paginas: 303-308
Archivo PDF: 104.57 Kb.


RESUMEN

Se reporta el caso de una paciente sometida a cirugía urgente de aorta infra-rrenal que en el postoperatorio inmediato desarrolla paraplejía. Cuando se emplea un bloqueo epidural existe el riesgo de complicaciones atribuibles a la punción o los fármacos. En este caso, la paraplejía fue secundaria a isquemia medular por el procedimiento quirúrgico. Este tipo de complicaciones son raras después de cirugía de aorta infrarrenal, por lo que si empleamos un bloqueo epidural, debemos de seguir algunas precauciones para evitar complicaciones atribuibles a la técnica anestésica.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Nishimori M, Ballantyne JC, Low JH. Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery. Cochrane Database Syst Rev 2006;3:CD005059.

  2. Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, Sage D, Futter M, Saville G, Clark T, MacMahon S. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomized trials. BMJ 2000;321:1493.

  3. Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004;101:950-9.

  4. Cameron CM, Scott DA, McDonald WM, Davies MJ. A review of neuraxial epidural morbidity: experience of more than 8,000 cases at a single teaching hospital. Anesthesiology 2007;106:997-1002.

  5. Christie IW, McCabe S. Major complications of epidural analgesia after surgery: results of a six-year survey. Anaesthesia 2007;62:335-41.

  6. Küker W, Weller M, Klose U, Krapf H, Dichgans J, Nägele T. Diffusion-weighted MRI of spinal cord infarction-high resolution imaging and time course of diffusion abnormality. J Neurol 2004;251:818-24.

  7. Uefuji T, Maekawa S. Permanent paraplegia following epidural and general anestesia: two case reports. Masui 1996:453-457.

  8. Kawaguchi C, Niwa K, Hamano H, Haida M, Shinohara Y. Long-term gadolinium-enhancement of cauda equine on MRI in a case of spinal cord infarction. Rinsho Shinkeigaku 1998;38:440-445.

  9. Hong DK, Lawrence HM. Anterior spinal artery syndrome following total hip arthroplasty under epidural anaesthesia. Anaesth Intensive Care 2001;29:62-6.

  10. Chan LL, Kumar AJ, Leeds NE, Forman AD. Post-epidural analgesia spinal cord infarction: MRI correlation. Acta Neurol Scand 2002;105:344-8.

  11. Bhuiyan MS, Mallick A, Parsloe M. Post-thoracotomy paraplegia coincident with epidural anaesthesia. Anaesthesia 1998;53:583-6.

  12. Weinberg L, Harvey WR, Marshall RJ. Post-operative paraplegia following spinal cord infarction. Acta Anaesthesiol Scand 2002;46:469-72.

  13. Stéphanie M, Georges R, Pierre-Antoine L, Guy K, Marc F. Neurologic Dysfunction After Major Thoracic Surgery in a Patient with Severe Arteriosclerotic Disease Receiving Epidural Analgesia. Anesth Analg 2007;104:204-206.

  14. Bhuiyan MS, Mallick A, Parsloe M. Post-thoracotomy paraplegia coincident with epidural anaesthesia. Anaesthesia 1998;53:583-6.

  15. Kobrine AI, Doyle TF, Martins AN. Autoregulation of spinal cord blood flow. Clin Neurosurg 1975;22:573-581.

  16. Hickey R, Albin MS, Bunegin L, Gelineau J. Autoregulation of spinal cord blood flow: is the cord a microcosm of the brain? Stroke 1986;17:1183-9.

  17. Tsuji T, Matsuyama Y, Sato K, Iwata H. Evaluation of spinal cord blood flow during prostaglandin E1-induced hypotension with power Doppler ultrasonography. Spinal Cord 2001;39:31-6.

  18. Singh U, Silver JR, Welply NC. Hypotensive infarction of the spinal cord. Paraplegia. 1994;32:314-22.

  19. Amoiridis G, Wöhrle JC, Langkafel M, Maiwurm D, Przuntek H. Spinal cord infarction after surgery in a patient in the hyperlordotic position. Anesthesiology 1996;84:228-30.

  20. Hong DK, Lawrence HM. Anterior spinal artery syndrome following total hip arthroplasty under epidural anaesthesia. Anaesth Intensive Care. 2001;29:62-6.

  21. Neal JM. Anatomy and Pathophysiology of Spinal Cord Injury Associated with Regional Anesthesia and Pain Medicine. Reg Anesth Pain Med 2008;33:423-34.

  22. Ferguson LR, Bergan JJ, Conn J, Yao JS. Spinal ischemia following abdominal aortic surgery. Ann Surg 1975;181:267-272.

  23. Heinemann MK, Brassel F, Herzog T, Dresler C, Becker H, Borst HG. The role of spinal angiography in operations on the thoracic aorta: myth or reality? Ann Thorac Surg 1998;65:346-51.

  24. Koshino T, Murakami G, Morishita K, Mawatari T, Abe T. Does the Adamkiewicz artery originate from the larger segmental arteries? J Thorac Cardiovasc Surg 1999;117:898-905.

  25. Cheshire WP, Santos CC, Massey EW, Howard JF. Spinal cord infarction: etiology and outcome. Neurology 1996;47:321-30.

  26. Connolly JE. Hume Memorial lecture. Prevention of spinal cord complications in aortic surgery. Am J Surg. 1998;176:92-101.

  27. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg 1993;17:357-68.

  28. Hilgenberg AD. Spinal cord protection for thoracic aortic surgery. Cardiol Clin 1999;17:807-13.

  29. Dimakakos P, Arapoglou B, Katsenis K, Vlahos L, Papadimitriou J. Ischemia of spinal cord following elective operative procedures of the infrarenal abdominal aorta. J Cardiovasc Surg (Torino) 1996;37:243-7.

  30. Tönz M, Redaelli C, Pasic M, von Segesser LK, Turina M. Paraplegia, a catastrophic complication of interventions on the infrarenal aorta. Helv Chir Acta 1993;60:177-81.

  31. Jacobs MJ, de Mol BA, Elenbaas T, Mess WH, Kalkman CJ, Schurink GW, Mochtar B. Spinal cord blood supply in patients with thoracoabdominal aortic aneurysms. J Vasc Surg 2002;35:30-7.

  32. Cambria RP, Davison JK, Carter C, Brewster DC, Chang Y, Clark KA, Atamian S. Epidural cooling for spinal cord protection during thoracoabdominal aneurysm repair: a five-year experience. J Vasc Surg 2000;31:1093-102.

  33. Estrera AL, Miller CC 3rd, Huynh TT, Porat E, Safi HJ. Neurologic outcome after thoracic and thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 2001;72:1225-30.

  34. Ogino H, Sasaki H, Minatoya K, Matsuda H, Yamada N, Kitamura S. Combined use of adamkiewicz artery demonstration and motor-evoked potentials in descending and thoracoabdominal repair. Ann Thorac Surg 2006;82:592-6.

  35. Nakazawa K, Tohyama S, Masuda A, Kawatani M, Masuzawa Y, Makita K. Epidural cooling for thoracoabdominal aortic surgery. Masui 2002;51:869-74.

  36. Horlocker T, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT, Brown DL, Heit JA, Mulroy MF, Rosenquist RW, Tryba M, Yuan C. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy. Reg Anesth Pain Med 2010;35:64-101.

  37. Carrillo ER, Zaragoza LG, Mejía GE, Rivera FJ, Moyao GD, Genis RMA, Ortiz MD, Suárez MMPB, Tenopala VS, Covarrubias GA, Marrón PM, Silva BL, García RW, Márquez GJ, Rentería E, Garduño A, Panoso A, López LL. Guía de Práctica Clínica Basada en la Evidencia para el Manejo de Anestesia Regional y Anticoagulación. Rev Mex Anest 2009;32:s247-s274.




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