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2009, Number 1

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Rev Med Hosp Gen Mex 2009; 72 (1)

Accidental dural puncture during epidural block in Hospital General de México

López-Herranz GP, Giraldo CLF

Language: Spanish
References: 23
Page: 26-30
PDF size: 75.34 Kb.


ABSTRACT

The accidental dural puncture (ADP), is a potential complication during the epidural blockade (EPB), with the consequent appearance of headache. The ADP, is related to multiple factors, probably one of them is the resident learning curve in training. Objective: To determine the prevalence and factors of risk of the ADP in the Hospital General de México. Material and method: A prospective, cross-sectional, observational and descriptive study was made. Included men and women, ASA I-III (American Society of Anesthesiologists) with EPB. The variables were: Weight, size, corporal mass index (CMI), personnel who placed the BED, intervertebral space, boarding via, Tuohy needle type, calibrates, needle bevel direction, epidural space identify proves, rotation of the needle and number of attempts to place the Tuohy needle in the epidural space. Results: ADP prevalence was 2.7%. Of 58 ADP, 37 correspond to residents (63.7%) and 21 (36.2%) to anesthesiologist. First year resident correspond 31 (53.4%), second year resident, 06 (10.3%), and the prevalence for anesthesiologist was 0.99%. In June and August ADP was frequently. In lumbar region occur 52 ADP. Conclusions: Accidental dural puncture incidence is similar to other series. Middle of resident training, ADP is greater. Factors like gauge needle, re-sterilizable Tuohy needle, longitudinal orientation, has been associated more frequently with ADP.


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