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Revista Cubana de Anestesiología y Reanimación

2017, Número 1

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Revista Cubana de Anestesiología y Reanimación 2017; 16 (1)


Hipotensión arterial después de la anestesia subaracnoidea en la cesárea: incidencia y factores de riesgo

González PSF

Idioma: Español
Referencias bibliográficas: 41
Paginas: 1-14
Archivo PDF: 184.43 Kb.


RESUMEN

Introducción: la hipotensión materna es la complicación más frecuente de la raquianestesia por cesárea.
Objetivo: identificar los factores de riesgo que se asocian con la hipotensión arterial después de la anestesia subaracnoidea durante la cesárea.
Métodos: en el hospital General Docente "Ricardo Santana Martínez" del municipio Fomento, provincia de Sancti Spíritus entre enero de 2005 hasta diciembre de 2014, se realizó un estudio observacional, analítico, longitudinal, de cohortes y retrospectivo en 1306 gestantes, que recibieron raquianestesia por cesárea para la asociación con episodios hipotensivos mediante análisis univariado y regresión logística múltiple. La hipotensión arterial se definió como una disminución de la presión arterial sistólica ‹ 100mmhg.
Resultados: se encontró hipotensión materna en 922 casos (70,6 %). El análisis univariado identificó el tipo de cesárea, la altura de la madre, el índice de masa corporal, la rotura del saco amniótico, la historia de hipertensión arterial, la historia de hipotensión arterial, el peso del recién nacido y el nivel sensitivo asociados con hipotensión arterial. La regresión logística múltiple detectó la rotura del saco amniótico, historia de hipertensión arterial, nivel sensitivo D 1-D4 y peso del recién nacido ≥ 2500g como factores independientes de hipotensión arterial.
Conclusiones: la identificación de factores de riesgo es un paso crucial para el diseño de un protocolo anestésico para la prevención de la hipotensión materna y la disminución de su incidencia después de la anestesia subaracnoidea para la cesárea.


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