Factores predictivos de localización dificultosa del espacio epidural
Faitot V, Ourchane R, Dahmani S, Magheru M, Nebout S, Gomas F, Katz A, Salomon L, Keïta-Meyer H. An observational study of factors leading to difficulty in resident anaesthesiologists identifying the epidural space in obstetric patients. Int J Obstet Anesth 2011, 20:124-127
DOI:
https://doi.org/10.30445/rear.v3i8.463Palabras clave:
anestesia obstétrica, epidural, formación, obstetriciaResumen
Los múltiples intentos en la colocación de una aguja epidural ocasionan molestias a las pacientes y pueden provocar complicaciones: cefalea postpunción dural, punción traumática de un nervio o hematoma espinal.
El objetivo de este estudio es identificar los factores que dificultan la canulación del espacio epidural en residentes sin experiencia en anestesia obstétrica. En estudios previos la experiencia del anestesiólogo resultaba controvertida.
Citas
1. Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology 1997;87:479–86.
2. Lerner SM, Gutterman P, Jenkins F. Epidural hematoma and paraplegia after numerous lumbar punctures. Anesthesiology 1973;39:550–1.
3. Puolakka R, Haasio J, Pitkanen MT, Kallio M, Rosenberg PH. Technical aspects and postoperative sequelae of spinal and epidural anesthesia: a prospective study of 3230 orthopedic patients. Reg Anesth Pain Med 2000;25:488–97.
4. Wulf H. Epidural anaesthesia and spinal haematoma. Can J Anaesth 1996;43:1260–71. (PubMed) (pdf)
5. Ellinas EH, Eastwood DC, Patel SN, Maitra-D’Cruze AM, Ebert TJ. The effect of obesity on neuraxial technique difficulty in pregnant patients: a prospective, observational study. Anesth Analg 2009;109:1225–31.
6. Sprung J, Bourke DL, Grass J et al. Predicting the difficult neuraxial block: a prospective study. Anesth Analg 1999;89:384–9.
7. Atallah MM, Demian AD, Shorrab AA. Development of a difficulty score for spinal anaesthesia. Br J Anaesth 2004;92:354–60.
8. de Filho GR, Gomes HP, da Fonseca MH, Hoffman JC, Pederneiras SG, Garcia JH. Predictors of successful neuroaxial block: a prospective study. Eur J Anaesthesiol 2002;19:447–51.
9. Hanafi Y, Adib A, Abbad A et al. Evaluation of difficult predictive score of neuraxial block in obstetrics. Ann Fr Anesth Reanim 2007;26:R330.
10. Renck H. Neurological complications of central nerve blocks. Acta Anaesthesiol Scand 1995;39:859–68. (PubMed)
11. Hood DD, Dewan DM. Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology 1993;79:1210–8.
12. Poobalan AS, Aucott LS, Gurung T, Smith WC, Bhattacharya S. Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta-analysis of cohort studies. Obes Rev 2009;10:28–35.
13. Rocke DA, Murray WB, Rout CC, Gouws E. Relative risk analysis of factors associated with difficult intubation in obstetric anesthesia. Anesthesiology 1992;77:67–73.
14. Weiss JL, Malone FD, Emig D et al. Obesity, obstetric complications and cesarean delivery rate – a population-based screening study. Am J Obstet Gynecol 2004;190:1091–7.
15. Kopacz DJ, Neal JM, Pollock JE. The regional anesthesia ‘‘learning curve’’. What is the minimum number of epidural and spinal blocks to reach consistency? Reg Anesth 1996;21:182–90.
2. Lerner SM, Gutterman P, Jenkins F. Epidural hematoma and paraplegia after numerous lumbar punctures. Anesthesiology 1973;39:550–1.
3. Puolakka R, Haasio J, Pitkanen MT, Kallio M, Rosenberg PH. Technical aspects and postoperative sequelae of spinal and epidural anesthesia: a prospective study of 3230 orthopedic patients. Reg Anesth Pain Med 2000;25:488–97.
4. Wulf H. Epidural anaesthesia and spinal haematoma. Can J Anaesth 1996;43:1260–71. (PubMed) (pdf)
5. Ellinas EH, Eastwood DC, Patel SN, Maitra-D’Cruze AM, Ebert TJ. The effect of obesity on neuraxial technique difficulty in pregnant patients: a prospective, observational study. Anesth Analg 2009;109:1225–31.
6. Sprung J, Bourke DL, Grass J et al. Predicting the difficult neuraxial block: a prospective study. Anesth Analg 1999;89:384–9.
7. Atallah MM, Demian AD, Shorrab AA. Development of a difficulty score for spinal anaesthesia. Br J Anaesth 2004;92:354–60.
8. de Filho GR, Gomes HP, da Fonseca MH, Hoffman JC, Pederneiras SG, Garcia JH. Predictors of successful neuroaxial block: a prospective study. Eur J Anaesthesiol 2002;19:447–51.
9. Hanafi Y, Adib A, Abbad A et al. Evaluation of difficult predictive score of neuraxial block in obstetrics. Ann Fr Anesth Reanim 2007;26:R330.
10. Renck H. Neurological complications of central nerve blocks. Acta Anaesthesiol Scand 1995;39:859–68. (PubMed)
11. Hood DD, Dewan DM. Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology 1993;79:1210–8.
12. Poobalan AS, Aucott LS, Gurung T, Smith WC, Bhattacharya S. Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta-analysis of cohort studies. Obes Rev 2009;10:28–35.
13. Rocke DA, Murray WB, Rout CC, Gouws E. Relative risk analysis of factors associated with difficult intubation in obstetric anesthesia. Anesthesiology 1992;77:67–73.
14. Weiss JL, Malone FD, Emig D et al. Obesity, obstetric complications and cesarean delivery rate – a population-based screening study. Am J Obstet Gynecol 2004;190:1091–7.
15. Kopacz DJ, Neal JM, Pollock JE. The regional anesthesia ‘‘learning curve’’. What is the minimum number of epidural and spinal blocks to reach consistency? Reg Anesth 1996;21:182–90.
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Aguado Borja-Fos, M. A., & Echeverri Vélez, M. Factores predictivos de localización dificultosa del espacio epidural: Faitot V, Ourchane R, Dahmani S, Magheru M, Nebout S, Gomas F, Katz A, Salomon L, Keïta-Meyer H. An observational study of factors leading to difficulty in resident anaesthesiologists identifying the epidural space in obstetric patients. Int J Obstet Anesth 2011, 20:124-127. Revista Electrónica AnestesiaR, 3(8), 3. https://doi.org/10.30445/rear.v3i8.463
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