Articulos
2024
Diciembre
Median effective dose of spinal ropivacaine in combined spinal and epidural anesthesia for emergency cesarean delivery following failed vaginal delivery with epidural labor analgesia: a single‑blind, sequential dose‑finding study
Descripcion:his study aimed to estimate the median effective dose of intrathecal isobaric ropivacaine without opioid required for adequate cesarean delivery anesthesia after epidural labor analgesia.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/39196373/
What is‘genuine’ failure of neuraxial anaesthesia?
Descripcion:hat is ‘genuine’ failure of neuraxial anaesthesia? In their systematic review, Patel et al. want to give an answer to this question, but they risk gravely underestimating the issue [1]. Irrespective of the precise definition of neuraxial block failure, inadequate anaesthesia remains a euphemism for a failing neuraxial block: it can cause severe distress to the patient.
Url articulo:
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15723
Predictors of Failed Spinal Anesthesia After Intrathecal Injection of Local Anesthetic for Cesarean Delivery: Are We Omitting the Omission Variable Bias?
Descripcion:The incidence of failed spinal anesthesia varies widely in the obstetric literature. Although many risk factors have been suggested, their relative predictive value is unknown.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37014966/#:~:text=The%20most%20important%20predictors%20of,0.90%2D0.98%3B%20P%20%3D%20.
Total failure of spinal anesthesia for cesarean delivery, associated factors, and outcomes A retrospective case–control study
Descripcion:Spinal anesthesia is the anesthetic technique of choice for patients undergoing cesarean delivery. In the present study, total spinal anesthesia failure was defined as a case when an absent blockade or inadequate surgery required general anesthesia administration with an endotracheal tube.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35801788/
Prevention and management of intra-operative pain during caesarean section under neuraxial anaesthesia: a technical and interpersonal approach
Descripcion:A woman who experiences pain during caesarean section under neuraxial anaesthesia is at risk of adverse psychological sequelae. Litigation arising from pain during caesarean section under neuraxial anaesthesia has replaced accidental awareness under general anaesthesia as the most common successful medicolegal claim against obstetric anaesthetists.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35325933/
Inadequate neuraxial anaesthesia in patients undergoing elective caesarean section: a systematic review
Descripcion:Neuraxial anaesthesia is widely utilised for elective caesarean section, but the prevalence of inadequate intra-operative anaesthesia is unclear.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35064923/
Comparison between 10 and 12 mg doses of intrathecal hyperbaric (0.5%) bupivacaine on sensory block level after first spinal failure in cesarean section: A double-blind, randomized clinical trial
Descripcion:Reducing adverse effects during cesarean delivery and improving the quality of sensory blocks with appropriate doses of intrathecal hyperbaric bupivacaine can play an important role in the safe management of cesarean delivery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/36267612/
The Incidence and Predictors of Failed Spinal Anesthesia After Intrathecal Injection of Local Anesthetic for Cesarean Delivery: A Single-Center, 9-Year Retrospective Review
Descripcion:The incidence of failed spinal anesthesia varies widely in the obstetric literature. Although many risk factors have been suggested, their relative predictive value is unknown. The primary objective of this retrospective cohort study was to determine the incidence of failed spinal anesthesia for cesarean deliveries at a tertiary care obstetric hospital, and its secondary objectives were to identify predictors of failed spinal anesthesia in the obstetrics population and quantify their relative importance in a predictive model for failure.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37014966/
Failed spinal anesthesia for cesarean delivery: prevention, identification and management
Descripcion:There is an increasing awareness of the significance of intraoperative pain during cesarean delivery. Failure of spinal anesthesia for cesarean delivery can occur preoperatively or intraoperatively.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/38362822/
Noviembre
Combined spinal-epidural vs. dural puncture epidural techniques for labour analgesia: a randomised controlled trial*
Descripcion:Combined spinal-epidural vs. dural puncture epidural techniques for labour analgesia: a randomised controlled trial*
Url articulo:
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16433
Anaesthetists should adopt a patient-centric approach to labour analgesia and embrace the combined spinal- epidural
Descripcion:Anaesthetists should adopt a patient-centric approach to labour analgesia and embrace the combined spinal- epidural
Url articulo:
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/10.1111/anae.16465
Complicaciones neurológicas e infecciones tras analgesia neuroaxial del parto
Descripcion:Most peripartum neurological complications are due to compressive neuropathy secondary to obstetric causes and usually recover sponta- neously. The incidence of permanent neurological injury after neuraxial anesthesia is very rare. The suspicion and rapid evaluation of a possible complication favors a good outcome.
Url articulo:
https://revistachilenadeanestesia.cl/revchilanestv5127091144/
Obstetric-related Neurological Complications Mark I. Zakowski, MD
Descripcion:Obstetric-related Neurological Complications
Url articulo:
https://journals.lww.com/anesthesiaclinics/citation/2014/05230/obstetric_related_neurological_complications.4.aspx
Statement on Neurologic Complications of Neuraxial Analgesia/Anesthesia in Obstetrics
Descripcion:he purpose of this consensus statement is to discuss the risks of neurologic complications associated with neuraxial techniques in the obstetric population by describing the types and pathophysiology of neurologic deficits and/or injury, identifying techniques for recognition and evaluation of deficits and/or injury, and providing recommendations for best practices.
Url articulo:
https://www.asahq.org/standards-and-practice-parameters/statement-on-neurologic-complications-of-neuraxial-analgesia-anesthesia-in-obstetrics
Risk factors for peripheral nerve injuries following neuraxial labour analgesia: a nested case–control study
Descripcion:ost-partum lower extremity motor and sensory dysfunctions occur in 0.1-9.2‰ of deliveries. While macrosomia, lithotomy position and forceps use are well-identified causes of peripheral nerve injuries, additional contributors such as patient condition and anaesthesia care may also have to be considered.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/28766691/
Octubre
Amniotic fluid embolism: lessons for rapid recognition and intervention
Descripcion:Amniotic fluid embolism is a rare, often fatal complication of labor and delivery. The classic presentation is the sudden onset of a triad of clinical manifestations: hypoxia, hypotension and coagulopathy. Understanding of the syndrome as an immunologically mediated, complicated and often catastrophic maternal response to fetal or placental antigens is coming into focus.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/34458179/
Consumptive Coagulopathy Involving Amniotic Fluid Embolism: The Importance of Earlier Assessments for Interventions in Critical Care
Descripcion:Amniotic fluid embolism is a rare disease that induces fatal coagulopathy; however, due to its rarity, it has not yet been examined in detail. The strict diagnostic criteria by Clark for amniotic fluid embolism include severe coagulopathy complicated by cardiopulmonary insufficiency, whereas the Japanese criteria also include postpartum hemorrhage or Disseminated Intravascular Coagulation in clinical practice.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33031152/
Society for Maternal-Fetal Medicine Special Statement: Checklist for initial management of amniotic fluid embolism
Descripcion:Amniotic fluid embolism is a rare syndrome characterized by sudden cardiorespiratory collapse during labor or soon after delivery. Because of its rarity, many obstetrical providers have no experience in managing amniotic fluid embolism and may therefore benefit from a cognitive aid such as a checklist.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33417901/
Anesthetic management of amniotic fluid embolism -- a multi-center, retrospective, cohort study
Descripcion:Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/29166810/
Maternal death analysis based on data from the nationwide registration system in Japan (2010–2018)
Descripcion:The maternal mortality rate in Japan was 3.5 per 100 000 live births in 2017, similar to that reported in other developed countries. To reduce the number of maternal deaths, a Japanese nationwide registration and analysis system was implemented in 2010.
Url articulo:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8248185/#:~:text=Between%20January%202010%20and%20April,embolism%20and%20acute%20pulmonary%20thromboembolism.
Recurrent Cardiac Arrests Due to Amniotic Fluid Embolism
Descripcion:Amniotic fluid embolism (AFE) is a rare but devastating complication of pregnancy and is associated with high morbidity and mortality. Identifiable maternal risk factors for AFE include older age, multiparity, cesarean section, and placenta previa, while fetal factors include male gender, fetal distress, and death.
Url articulo:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8943441/
Post-dural puncture headache diagnosis and management
Descripcion:Epidural analgesia, commonly used to alleviate labor pain, is not without complication. The most common complication associated with labor epidural analgesia (LEA) is Unintentional Dural Puncture (UDP), where many professionals go on to develop a Post Dural Puncture Headache (PDPH). Spinal anesthesia can also result in PDPH.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35659954/
Intrathecal catheter use after accidental dural puncture in obstetric patients: literature review and clinical management recommendations
Descripcion:If an accidental dural puncture occurs, one option is to insert a catheter and use it as an intrathecal catheter. This avoids the need for a further injection and can rapidly provide labour analgesia and anaesthesia for caesarean section.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33476424/
Intrathecal catheter placement after inadvertent dural puncture in the obstetric population: management for labour and operative delivery. Guidelines from the Obstetric Anaesthetists’ Association
Descripcion:Anaesthetists of all grades who work on a labour ward are likely to be involved in the insertion or management of an intrathecal catheter after inadvertent dural puncture at some point in their careers.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/39327940/
Effective prevention of post-dural puncture headache with insertion of an intrathecal catheter in parturients: a retrospective study and meta-analysis
Descripcion:Accidental dural puncture is a common complication of labour analgesia. It can trigger post-dural puncture headache, with associated morbidity and increased costs. Intrathecal catheter placement is a prophylactic procedure which can reduce incidence and severity of post-dural puncture headache.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37475027/
The effect of placement and management of intrathecal catheters following accidental dural puncture on the incidence of postdural puncture headache and severity: a retrospective real-world study
Descripcion:Accidental dural puncture during an attempt to establish labour epidural analgesia can result in postdural puncture headache and long-term debilitating conditions. Epidural blood patch, the gold standard treatment for this headache, is invasive and not always successful.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37439056/
Comparison of Chloroprocaine Versus Lidocaine With Epinephrine, Sodium Bicarbonate, and Fentanyl for Epidural Extension Anesthesia in Elective Cesarean Delivery: A Randomized, Triple-Blind, Noninferiority Study
Descripcion:or emergent intrapartum cesarean delivery (CD), the literature does not support the use of any particular local anesthetic solution to extend epidural analgesia to cesarean anesthesia.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/32852294/
Choice of local anaesthetic for epidural caesarean section: a Bayesian network meta-analysis
Descripcion:Rapid-onset epidural local anaesthesia can avoid general anaesthesia for caesarean delivery. We performed a Bayesian network meta-analysis of direct and indirect comparisons to rank speed of onset of the six local anaesthetics most often used epidurally for surgical anaesthesia for caesarean delivery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/31867718/
Risk factors for failure of conversion from epidural labor analgesia to cesarean section anesthesia and general anesthesia incidence: an updated meta-analysis
Descripcion:Ongoing controversies persist regarding risk factors associated with the failure of transition from epidural labor analgesia to cesarean section anesthesia, including the duration of labor analgesia, gestational age, and body mass index (BMI).
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37926901/
Conversion of Labour Epidural Analgesia to Anaesthesia for Caesarean Delivery
Descripcion:Between 2017 and 2018, more than 100,000 emergency Caesarean deliveries were carried out in England, 21% of which were performed with epidural anaesthesia alone.1
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807843/
Risk factors for uterine atony/postpartum hemorrhage requiring treatment after vaginal delivery
Descripcion:To identify risk factors for uterine atony or hemorrhage.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788839/
Epidural-related maternal fever: incidence, pathophysiology, outcomes, and management
Descripcion:Epidural-related maternal fever affects 15% to 25% of patients who receive a labor epidural. Two meta-analyses demonstrated that epidural-related maternal fever is a clinical phenomenon, which is unlikely to be caused by selection bias.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/36925412/
Maternal fever in labor: etiologies, consequences, and clinical management
Descripcion:Intrapartum fever is common and presents diagnostic and treatment dilemmas for the clinician. True maternal sepsis is rare; only an estimated 1.4% of women with clinical chorioamnionitis at term develop severe sepsis.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/36997396/
Serum Magnesium Level as a Biomarker to Predict the Risk of Labor Epidural Anesthesia Associated Fever
Descripcion:Excessive pain will have adverse effects on the mother and fetus. Labor epidural analgesia greatly reduces the pain, which is widely carried out abroad. Labor epidural anesthesia-associated fever (LEAF) is the biggest problem for labor epidural anesthesia. This study aimed to evaluate the clinical value of serum magnesium levels to predict the LEAF.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637208/
Cytokines in the perinatal period – Part I
Descripcion:Successful pregnancy requires a state of immune homeostasis. Maternal tolerance of the genetically distinct fetoplacental unit is in part mediated by maternal and fetal pro- and anti-inflammatory cytokines; these cytokines have also been implicated in different pregnancy-related pathologic states.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/26970932/
Interventions for the prevention or treatment of epidural-related maternal fever: a systematic review and meta-analysis
Descripcion:Epidural-related maternal fever in women in labour has consequences for the mother and neonate. There has been no systematic review of preventive strategies.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35934529/
The rise in maternal temperature associated with regional analgesia in labour is harmful and should be treated
Descripcion:Fusi et al. in 1989 first reported the association of raised maternal temperature with the use of epidural analgesia in labour when compared to women receiving opioid analgesia.1 Since then a number of observational and randomised studies have confirmed this association.2–10 About 6–23% of women in labour with epidural analgesia will develop clinical pyrexia >38°C. The degree of rise has been estimated to be 1°C for every seven hours of exposure to epidural analgesia.1 Thus, the clinical observation of pyrexia in labour becomes more likely after five hours of exposure to epidural analgesia
Url articulo:
https://www.obstetanesthesia.com/article/S0959-289X(03)00047-5/abstract
Retrospective study of intrapartum fever in term pregnancies and adverse obstetric and neonatal outcomes
Descripcion:Intrapartum fever is a well-known predisposing factor for severe perinatal outcomes. Herein, we explored the intrapartum features, obstetric outcomes, and neonatal outcomes in relation to the extent of intrapartum fever via three group analyses.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618262/
Septiembre
Relapsing Guillain-Barre syndrome in pregnancy and postpartum
Descripcion:Guillain-Barre syndrome (GBS) rarely complicates pregnancy, but can be associated with high maternal and perinatal morbidity if not properly identified and treated. A high index of suspicion, supportive measures, access to intensive care unit and intravenous immunoglobulin (IVIG) therapy are cornerstones of management in GBS complicating pregnancy.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162029/
Anesthetic management of a parturient with Guillain–Barre syndrome posted for emergency caesarian section
Descripcion:Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barré syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611080/
Anesthesia for cesarean section in pregnant woman with Guillain Barré syndrome: a case report
Descripcion:Guillain-Barre syndrome during pregnancy is considered a rare neurological complication, and there is no consensus in literature for anesthetic management for cesarean section in such patients. The objective of this paper is to report the case of a pregnant woman with Guillain-Barre syndrome undergoing cesarean section.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/23931254/#:~:text=The%20anesthetic%20technique%20used%20was,for%20both%20mother%20and%20neonate.
WALKING EPIDURAL
Descripcion:Una baja concentración de anestésicos locales asociada a los opiáceos preservaría la capacidad de caminar de la parturienta, ya que la disminución en la dosis de anestésicos locales reduce el bloqueo motor asociado a la analgesia epidural. Comparación entre levobupivacaina 0.0625% y ropivacaina 0.075% + fentanilo 2 mcg/ml.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37528373/
Does Preoperative Coffee Consumption Prevent Intraoperative Hypotension in Cesarean Section Surgeries?
Descripcion:In this study, we evaluated the effects of a cup of coffee given to patients before surgery in a cesarean section by means of intraoperative hypotension, ephedrine requirement, and the incidence of post-dural puncture headache (PDPH).
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290372/#:~:text=Conclusions%3A%20Consumption%20of%20a%20single,ephedrine%20usage%20in%20cesarean%20sections.
Agosto
Uterine atony
Descripcion:Postpartum hemorrhage (PPH) is the leading preventable cause of maternal morbidity and mortality worldwide. Uterine atony is identified as the underlying etiology in up to 80% of PPH.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35102109/
Preventing postpartum hemorrhage after cesarean delivery: a network meta-analysis of available pharmacologic agents
Descripcion:Postpartum hemorrhage causes a quarter of global maternal deaths. The World Health Organization recommends oxytocin as the first line agent to prevent hemorrhage during cesarean delivery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/34534498/
Interventions of Postpartum Hemorrhage
Descripcion:Postpartum hemorrhage is a common and potentially life-threatening obstetric complication, with successful management relying heavily on early identification of hemorrhage and prompt interven- tion.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37204172/
Calcium chloride for the prevention of uterine atony during cesarean delivery: A pilot randomized controlled trial and pharmacokinetic study
Descripcion:To assess the feasibility, patient tolerance, pharmacokinetics, and potential effectiveness of a randomized controlled trial protocol investigating intravenous calcium chloride for the prevention of uterine atony during cesarean delivery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35447502/
Uterine Atony: An Innovative Dutta’s Scoring System for Elective Cesarean Section
Descripcion:Uterine atony appears suddenly and is mostly unpredictable and accounts for 80% of causes of postpartum hemorrhage (PPH), it is also one of the important causes of maternal death.
Url articulo:
https://www.researchgate.net/publication/304229941_Uterine_Atony_An_Innovative_Dutta's_Scoring_System_for_Elective_Cesarean_Section
Risk Factors for Atonic Postpartum Hemorrhage
Descripcion:To identify and quantify risk factors for atonic postpartum hemorrhage.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336570/
Panic disorder during pregnancy: A scoping review
Descripcion:Panic Disorder is a serious anxiety disorder, and one of the severe mental problems that impacts mothers’ mental health and fetal health as well.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004808/
Non-pharmacological interventions to reduce anxiety in pregnancy, labour and postpartum: A systematic review
Descripcion:The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns. Anxiety must therefore be reduced using different strategies.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/34464836/
Preoperative anxiety and its associated factors among women undergoing elective caesarean delivery: a cross-sectional study
Descripcion:Anxiety is a behavioral expression of tension and unpleasant emotion that arises from multifactorial dimensions that might increase the mortality of patients during anesthesia and surgery. This study aimed to verify the prevalence and associated factors of preoperative anxiety among women undergoing elective cesarean delivery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35978308/
HAMILTON M, The assessment of ANXIETY Rating Scale
Descripcion:The HAM-A was one of the first rating scales developed to measure the severity of anxiety symptoms, and is still widely used today in both clinical and research settings. The scale consists of 14 items, each defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety).
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/13638508/
Can propofol procedural sedation implementation increase the acceptance of spinal anesthesia during cesarean section?
Descripcion:Parturients are highly anxious preoperatively. The worries of spinal anesthesia may preclude its acceptance despite being recommended. Procedural sedation is not a routine during regional blocks, but it is sensible that anesthesiologists should provide their blocks comfortably. The proposal is that implementing the propofol procedural sedation (PPS) may increase the acceptance rate of spinal anesthesia for cesarean section.
Url articulo:
https://asja.springeropen.com/articles/10.1186/s42077-019-0043-9
Low-dose midazolam for anxiolysis for pregnant women undergoing cesarean delivery: a randomized trial
Descripcion:Anxiety and fear are common among pregnant women undergoing cesarean delivery. In addition to psychologically unpleasant, they can elicit endocrine and metabolic changes. Administration of benzodiazepines in this patient group is uncommon and investigation focusing on the topic is rare.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/34637858/
Julio
Ultrasound Assessment of the Vertebral Level of the Intercristal Line in Pregnancy
Descripcion:The intercristal line is known to most frequently cross the L4 spinous process or L4-5 interspace; however, it is speculated to be positioned higher during pregnancy because of the exaggerated lumbar lordosis. Clinical estimation of vertebral levels relying on the use of the intercristal line has been shown to often be inaccurate. We hypothesized that the vertebral level of the intercristal line determined by palpation would be higher than the level determined by ultrasound in pregnant women.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/21680856/
The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia
Descripcion:The radiological intercristal line (Tuffier's line) usually intersects the spine at the L4-L5 interspace. The intercristal line determined by palpation may be used erroneously as a surrogate for the true radiological Tuffier's line. We studied term pregnant women to establish the level at which a transverse line connecting the superior aspects of the iliac crests, as determined by palpation, intersects the lumbar spine, as assessed by ultrasound.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/21128128/
Costing anaesthetic practice An economic comparison of regional and general anaesthesia for varicose vein and inguinal hernia surgery
Descripcion:A computerised database of operating theatre activity was used to estimate the costs of regional and general anaesthesia for varicose vein and inguinal hernia surgery. Data retrieved for each procedure included the anaesthetic technique and drugs used, and the duration of anaesthesia, surgery and recovery. The costs of anaesthetic drugs and disposables, salary costs of the anaesthetic personnel and maintenance costs for anaesthetic equipment were considered. Drugs and disposables accounted for approximately 25% of the total cost of an anaesthetic. Anaesthetic times were 5 min longer for regional anaesthesia, but recovery times were 10 min shorter following regional anaesthesia for varicose vein surgery. Staff costs were dependent on the length of time each staff member spent with the patient. Although the number of cases was small, provision of a field block and sedation for inguinal hernia repair was considerably cheaper than other anaesthetic techniques.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/11069339/
Non-invasive ventilation in the treatment of ventilatory failure following corrective spinal surgery
Descripcion:Non-invasive positive pressure ventilation has previously been used successfully to treat both acute and chronic ventilatory failure secondary to a number of conditions, including scoliosis. We report two patients in whom it was used, on three separate occasions, to treat acute ventilatory failure following corrective spinal surgery. Non-invasive positive pressure ventilation may be useful postoperatively in high-risk patients undergoing major spinal surgery in an attempt to prevent intubation and its attendant complications.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/11251430/
Spinal Cord Trauma During Subarachnoid Anesthesia for Cesarean Delivery: A Case Report
Descripcion:al cord trauma can occur during subarachnoid blockade and can result in significant morbidity for the patient. Careful attention to lumbar insertion level is essential to prevent injury.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/30640276/
Rocuronium vs. succinylcholine for rapid sequence intubation: a Cochrane systematic review
Descripcion:This systemic review was performed to determine whether rocuronium creates intubating conditions comparable to those of succinylcholine during rapid sequence intubation of the trachea. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 2), MEDLINE (1966 to February Week 2 2015), and EMBASE (1988 to February 14 2015) for any randomised controlled trials or controlled clinical trials that reported intubating conditions comparing rocuronium and succinylcholine for rapid or modified rapid sequence intubation. The dose of rocuronium was at least 0.6 mg.kg-1 and succinylcholine was at least 1 mg.kg-1
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/28654173/
Accidental Awareness Under General Anesthesia During Cesarean Section: An Observational Study
Descripcion:A Caesarean section (CS) if performed under general anesthesia (GA) is a procedure with an increased risk of accidental awareness. This study aimed to examine the incidence of accidental awareness under GA in hospitals in the Republic of Srpska (Bosnia and Herzegovina) where GA for CS is performed in a significantly higher percentage compared to spinal anesthesia.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075182/
Paralysis analysis – does choice of muscle relaxant for obstetric general anaesthesia influence neonatal outcomes?
Descripcion:Several modifications to the well-known obstetric gen- eral anaesthetic technique, succinctly characterised by ‘Thio, Sux, Tube’, have been proposed over recent years and include the use of rocuronium instead of suxam- ethonium for neuromuscular blockade.1–3 However, the evidence base on which many such recommenda- tions are made is weak.
Url articulo:
https://www.obstetanesthesia.com/article/S0959-289X(17)30309-6/abstract
Total failure of spinal anesthesia for cesarean delivery, associated factors, and outcomes A retrospective case–control study
Descripcion:Spinal anesthesia is the anesthetic technique of choice for patients undergoing cesarean delivery. In the present study, total spinal anesthesia failure was defined as a case when an absent blockade or inadequate surgery required general anesthesia administration with an endotracheal tube. This study aimed to investigate factors related to this condition and report its maternal and neonatal outcomes.
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259130/#:~:text=Total%20spinal%20anesthesia%20failure%20was%20experienced%20by%20110%2F12%2C001%20patients,1.2%E2%80%933.1%3B%20P%20%3D%20.
Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study
Descripcion:General anaesthesia for obstetric surgery has distinct characteristics that may contribute towards a higher risk of accidental awareness during general anaesthesia. The primary aim of this study was to investigate the incidence, experience and psychological implications of unintended conscious awareness during general anaesthesia in obstetric patients. From May 2017 to August 2018, 3115 consenting patients receiving general anaesthesia for obstetric surgery in 72 hospitals in England were recruited to the study.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33434945/
General anesthesia in the parturient
Descripcion:Airway management in the pregnant woman presents unique challenges due to anatomic and physiological changes in preg- nancy, situational factors including urgency of surgery and iso- lated location, and lack of training opportunities because of the reduced number of obstetric general anesthetics. In addition, the presence of the fetus means that severe hypoxia during difficult airway management can potentially compromise 2 lives and creates a potential conflict between the needs of the mother and the fetus. Rapid sequence induction (RSI) with cricoid force (CF) and tracheal intubation for obstetric general anesthesia (GA) is considered the gold standard. The recently published Obstetric Anaesthetists Association/Difficult Airway Society (OAA/DAS) difficult airway guidelines emphasize the need for good planning, preparation, and effective team communication before perform- ing RSI to ensure a good outcome for the mother and the baby.
Url articulo:
https://journals.lww.com/anesthesiaclinics/citation/2021/05930/general_anesthesia_in_the_parturient.10.aspx
Rocuronium versus suxamethonium for rapid sequence induction of general an- aesthesia for caesarean section: influence on neonatal outcomes
Descripcion:In a previous study we compared rocuronium and suxamethonium for rapid-sequence induction of general anaesthesia for caesarean section and found no difference in maternal outcome. There was however, a significant difference in Apgar scores. As this was a secondary outcome, we extended the study to explore this finding on a larger sample.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/28606652/#:~:text=There%20was%20no%20difference%20between,unclear%20and%20warrants%20further%20investigation.
General anaesthesia in obstetrics
Descripcion:General anaesthesia was once the primary anaesthetic technique used in obstetrics, both for vaginal deliveries and Caesarean section (CS). As the field of obstetric anaesthesia has advanced, the use of GA has been largely replaced by neuraxial techniques. The latest decennial survey on obstetric anaesthesia practices in the USA reported a reduction of the use of GA for CS from 35% in 1981 to less than 25% in 2011, with the majority of cases corresponding to emergency procedures.1 It is currently estimated that about 6% of CS still require GA and tracheal intubation.2
Url articulo:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807964/
Lipid emulsions in the treatment of intoxications by local anesthesics and other drugs. Review of mechanisms of action and recommendations for use
Descripcion:Intravenous lipid emulsions (ILEs) have been used widely for the treatment of local anesthetic (LA) poisoning and have been proposed as a treatment for intoxication by other drugs. However, the degree of evidence for this kind of therapy is not strong, as it comes mostly from clinical cases. The aim of this narrative review is to describe the proposed mechanisms of action for ILEs in poisoning by LA and other drugs and to evaluate recent studies in animals that support the recommendations for their use and the experience in humans that support the use of ILESs in both LA and other drug poisoning.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/34140161/
American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version
Descripcion:The American Society of Regional Anesthesia and Pain Medicine (ASRA) periodically updates its practice advisories and associated cognitive aids. The 2020 version of the ASRA Local Anesthetic Systemic Toxicity checklist was created in response to user feedback, simulation studies and advances in medical knowledge. This report presents the 2020 version and discusses the rationale for its update.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33148630/
Intravenous lipid emulsion for local anaesthetic systemic toxicity in pregnant women: a scoping review
Descripcion:Local anaesthetic systemic toxicity (LAST) is a rare but life-threatening complication that can occur after local anaesthetic administration. Various clinical guidelines recommend an intravenous lipid emulsion as a treatment for local anaesthetic-induced cardiac arrest. However, its therapeutic application in pregnant patients has not yet been established. This scoping review aims to systematically identify and map the evidence on the efficacy and safety of intravenous lipid emulsion for treating LAST during pregnancy.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/38355477/
Oral Intake During Labor
Descripcion:Oral food intake during labor was raised as a risk factor for gastric- content aspiration in the 1940s, if a general anesthetic were required during labor. Nil by mouth policies were introduced since then in to reduce pulmonary aspiration after general anesthesia. However, ‘‘nil by mouth’’ has been challenged for more than a decade by clinicians, particularly midwives, due to lack of evidence to support that this policy is beneficial. Many midwives are concerned that fasting laboring women may lengthen labor duration, subsequently increase medical interven- tion, and compromise birth outcomes, based on theoretical metabolic principles and psychologic benefits.1–
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/17215704/
Effect of food intake during labour on obstetric outcome: randomised controlled trial
Descripcion:Consumption of a light diet during labour did not influence obstetric or neonatal outcomes in participants, nor did it increase the incidence of vomiting. Women who are allowed to eat in labour have similar lengths of labour and operative delivery rates to those allowed water only.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/19318702/
Limiting Oral Intake during Labor: Do We Have It Right?
Descripcion:Limiting oral intake during labor is part of our standard orders for most parturients admitted to labor and delivery suites, but what exactly is the science that underlies our rote inclusion of the order? As a specialty that prides itself on practice based on science, there is surprisingly little science underlying this practice. In this issue of Anesthesiology, Bouvet et al.1 shed a little more light on the subject, giving us better insight into gastric motility in parturients.
Url articulo:
https://pubs.asahq.org/anesthesiology/article/136/4/528/135650/Limiting-Oral-Intake-during-Labor-Do-We-Have-It
Pregnancy and Labor Epidural Effects on Gastric Emptying: A Prospective Comparative Study
Descripcion:The lack of reliable data on gastric emptying of solid food during labor has led to some discrepancies between current guidelines regarding fasting for solid food in the parturient. This prospective comparative study aimed to test the hypothesis that the gastric emptying fraction of a light meal would be reduced in parturients receiving epidural analgesia and with no labor analgesia compared with nonpregnant and pregnant women.
Url articulo:
https://pubs.asahq.org/anesthesiology/article/136/4/542/118338/Pregnancy-and-Labor-Epidural-Effects-on-Gastric
Practice Guidelines for Obstetric Anesthesia
Descripcion:PRACTICE guidelines are systematically developed rec- ommendations that assist the practitioner and patient in making decisions about health care. These recommendations may be adopted, modified, or rejected according to the clini- cal needs and constraints and are not intended to replace local institutional policies. In addition, practice guidelines devel- oped by the American Society of Anesthesiologists (ASA) are not intended as standards or absolute requirements, and their use cannot guarantee any specific outcome. Practice guidelines are subject to revision as warranted by the evolution of medi- cal knowledge, technology, and practice. They provide basic recommendations that are supported by a synthesis and analy- sis of the current literature, expert and practitioner opinion, open-forum commentary, and clinical feasibility data.
Url articulo:
https://pubs.asahq.org/anesthesiology/article/124/2/270/12693/Practice-Guidelines-for-Obstetric-AnesthesiaAn
Junio
Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean
Descripcion:The purpose of this article is to provide a summary of the Enhanced Recovery After Cesarean delivery (ERAC) protocol written by a Society for Obstetric Anesthesia and Perinatology (SOAP) committee and approved by the SOAP Board of Directors in May 2019. The goal of the consensus statement is to provide both practical and where available, evidence-based recommendations regarding ERAC.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33177330/
Does timing of urinary catheter removal after elective cesarean section affects postoperative morbidity?: a prospective randomized trial
Descripcion:To assess whether immediate (0 h), intermediate (after 6 h), or delayed (after 24 h) removal of an urinary catheter after elective caesarian section (CS) regarding, the rate of urinary retention with recatheterization, rate of symptomatic urinary tract infections (UTI), time of ambulation, and the length of hospital stay.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/30700178/
Postpartum urinary retention after cesarean delivery
Descripcion:To investigate the incidence of postpartum urinary retention (PUR) after cesarean delivery and determine which obstetric factors contribute to this problem.
Url articulo:
https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1016/j.ijgo.2007.05.037
Postpartum urinary retention: an expert review
Descripcion:Postpartum urinary retention is a relatively common condition that can have a marked impact on women in the immediate days following childbirth. If left untreated, postpartum urinary retention can lead to repetitive overdistention injury that may damage the detrusor muscle and the parasympathetic nerve fibers within the bladder wall. In rare circumstances, postpartum urinary retention may even lead to bladder rupture, which is a potentially life-threatening yet entirely preventable complication.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35932877/
Does Spinal Block Through Tattooed Skin Cause Histological Changes in Nervous Tissue and Meninges?: An Experimental Model in Rabbits
Descripcion:Although there is no documented evidence that tattoo pigments can cause neurological complications, the implications of performing neuraxial anesthesia through tattooed skin are unknown. In this study, we aimed to assess whether spinal puncture performed through tattooed skin of rabbits determines changes over the spinal cord and meninges. In addition, we sought to evaluate the presence of ink fragments entrapped in spinal needles.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/26222345/#:~:text=Conclusions%3A%20On%20the%20basis%20of,the%20presence%20of%20a%20stylet.
The need for an epidural ‘‘window of opportunity” in pregnant women with a lumbar tattoo
Descripcion:Pregnant women with lower back tattoos who wish to have an epidural placed during labour pose a dilemma to anesthesiologists. Clear guidelines have not been established. We reviewed the epidural risks in pregnant women with low back tattoos and have suggested precautionary measures to minimise them. Given the limited information available, and in the absence of a clear evidence-based medical contraindication, an epidural technique should not be excluded in those women with a lower back tattoo.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/29146017/
Society for Obstetric Anesthesia and Perinatology Consensus Statement: Monitoring Recommendations for Prevention and Detection of Respiratory Depression Associated With Administration of Neuraxial Morphine for Cesarean Delivery Analgesia
Descripcion:The majority of women undergoing cesarean delivery in the United States receive neuraxial morphine, the most effective form of postoperative analgesia for this surgery. Current American Society of Anesthesiologists (ASA) and American Society of Regional Anesthesia and Pain Medicine (ASRA) recommend respiratory monitoring standards following neuraxial morphine administration in the general surgical population that may be too frequent and intensive when applied to the healthy obstetric population receiving a single dose of neuraxial morphine at the time of surgery.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/31082964/
Mayo
Effective prevention of post-dural puncture headache with insertion of an intrathecal catheter in parturients: a retrospective study and meta-analysis
Descripcion:Accidental dural puncture is a common complication of labour analgesia. It can trigger post-dural puncture headache, with associated morbidity and increased costs. Intrathecal catheter placement is a prophylactic procedure which can reduce incidence and severity of post-dural puncture headache.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/37475027/
Accidental dural puncture during labor analgesia and obstetric outcomes in nulliparous women
Descripcion:The effect of accidental dural puncture during labor epidural analgesia on obstetric outcomes remains unexplored. In this retrospective cohort study, we tested the hypothesis that accidental dural puncture is associated with prolonged second stage of labor.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/30683572/#:~:text=Conclusion%3A%20Accidental%20dural%20puncture%20during,dural%20puncture%20and%20obstetric%20outcomes.
The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia
Descripcion:Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential morbidity associated with general anesthesia for cesarean delivery, thoughtful consideration of which patients with thrombocytopenia are likely to have an increased risk of spinal epidural hematoma with neuraxial procedures, and when these risks outweigh the relative benefits is important to consider and to inform shared decision making with patients.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/33861047/
How I treat thrombocytopenia in pregnancy
Descripcion:Thrombocytopenia is a common hematologic abnormality in pregnancy, encountered in ~10% of pregnancies. There are many possible causes, ranging from benign conditions that do not require intervention to life-threatening dis- orders necessitating urgent recognition and treatment. Although thrombocytopenia may be an inherited condition or predate pregnancy, most commonly it is a new diagnosis.
Url articulo:
https://ashpublications.org/blood/article/121/1/38/31058/How-I-treat-thrombocytopenia-in-pregnancy
Neuraxial labor analgesia: Initiation techniques
Descripcion:The ideal technique for labor analgesia would have a quick onset, predictable quality, and adjustable depth and duration. Moreover, it would be easy to perform and have minimal maternal and fetal side effects. A catheter-based neuraxial approach encompasses these desirable characteristics and includes the epidural, combined spinal epidural, dural puncture epidural, and intrathecal catheter techniques. In this review, we outline the unique technical con- siderations, analgesic characteristics, and side effect profiles for each technique that can ultimately impact the maternalefetal dyad.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/35659957/
Abril
Ácido tranexámico en hemorragia obstétrica, ¿profiláctico versus terapéutico?
Descripcion:reseña sobre la discusión de la pregunta ¿Usas ácido tranexámico de manera profiláctica o cuando inicia la hemorragia obstétrica?
Url articulo:
https://google.com.mx
Prophylactic tranexamic acid in Cesarean delivery: an updated meta-analysis with a trial sequential analysis
Descripcion:Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Although several studies on the prophylactic use of tranexamic acid (TXA) in parturients undergoing Cesarean delivery have been published, conflicting results raise questions regarding its use. Thus, we aimed to investigate the safety and efficacy of PPH prophylaxis with TXA.
Url articulo:
https://pubmed.ncbi.nlm.nih.gov/38453797/