Despertar Intraoperatorio y Estrés Postraumático en Anestesia. Conclusiones Extraídas del Estudio B-Aware
DOI:
https://doi.org/10.30445/rear.v4i3.365Palabras clave:
BIS, despertar intraoperatorio, DSM-IV, monitor, seguridadResumen
El despertar intraoperatorio (DIO) consiste en un inadecuado nivel de conciencia durante un procedimiento médico bajo anestesia general, que deja en el paciente recuerdo del mismo. En estudios ya clásicos sobre este tema se cifra su incidencia entre el 0,1% y 0,2% de los pacientes sometidos a anestesia general.
Sin embargo, la incidencia de DIO parece ser superior en aquellos pacientes en los que su condición clínica obliga a una administración más cautelosa de los fármacos usados para inducir y mantener el estado de anestesia general, para evitar en lo posible efectos secundarios conocidos a dichos fármacos (pacientes sometidas a procedimientos obstétricos, en cirugía cardíaca, y pacientes en shock o politraumatizados).
Citas
1.- Sebel, P.S., Bowdle, T.A., et al., The Incidence of Awareness During Anesthesia: A Multicenter United States Study. Anesth Analg, 2004; 99:833-9.
2.- Ghoneim, M.M. Awareness During Anesthesia. Anesthesiology, 2000; 92(2):597-602.
3.- Myles, P.S., Leslie, K., et al. Bispectral Index Monitoring to Prevent Awareness During Anaesthesia: The B-Aware Randomised Controlled Trial. Lancet, 2004; 363:1757-63.
4.- Rothenhäusler H-B, Grieser B, et al. Psychiatric and psicosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. Gen Hosp Psychiatry 2005;27:18-28.
5.- Tedstone J, Tarrier N. Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev 2003; 23:409-48.
6.- Stoll C, Schelling G, et al. Health-related quality of life and post-traumatic stress disorder in patients alter cardiac surgery and intensive care treatment. J Thorac Cardiovasc Surg 200; 120: 505-12.
7.- Dew MA, DiMartini AF, et al. Patterns and predictors of risk for depressive and anxiety-related disorders during the first three years after heart trasplantation. Psychosomatics 2000; 41:191-2.
8.- Ryding EL, Wijma B, et al. Postratumatic stress reactions alter emergent cesarean section. Acta Obstet Gynecol Scand 1997; 76: 856-61.
9.- Leslie K, Chan M, et al. Posttraumatic stress disorder in aware patients from the B-Aware trial. Anest Analg 2010; 110, 3. 823-8.
10.- Myles, P.S., Leslie, K., et al. Bispectral Index Monitoring to Prevent Awareness During Anaesthesia: The B-Aware Randomised Controlled Trial. Lancet, 2004; 363:1757-63.
11.- Horwitz R, Fenstein A. Methodologic standards and contradictory results in case-control research. Am J Med. 1979 Apr;66(4):556-64.
12.- Blake D, Weathers F, et al. The development of a clinician-administered PTSD scale. J Trauma Stress 1995; 8: 75-90.
13.- Osterman J, HopperJ, et al. Awareness during anaesthesia and the development of posttraumatic stress disorder. Gen Hosp Psychiatry 2001; 23: 198-204.
14.- Lennmarken C, Bildfords K, Enlund G, Samuelsson P, Sandin R. Victims of awareness. Acta Anaesthesiol Scand 2002; 46:229-31.
15.- Samuelsson P, Brudin L, Sandin R. Late psychological symptoms alter awareness among consecutively included surgical patients. Anaesthesiology 2007; 106: 26-32.
16.- Van der Kolk B, Fisler R. Dissociation and the fragmentary nature of traumatic memories: overview and exploratory study. J Trauma Stress 1995; 9: 505-25.
2.- Ghoneim, M.M. Awareness During Anesthesia. Anesthesiology, 2000; 92(2):597-602.
3.- Myles, P.S., Leslie, K., et al. Bispectral Index Monitoring to Prevent Awareness During Anaesthesia: The B-Aware Randomised Controlled Trial. Lancet, 2004; 363:1757-63.
4.- Rothenhäusler H-B, Grieser B, et al. Psychiatric and psicosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. Gen Hosp Psychiatry 2005;27:18-28.
5.- Tedstone J, Tarrier N. Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev 2003; 23:409-48.
6.- Stoll C, Schelling G, et al. Health-related quality of life and post-traumatic stress disorder in patients alter cardiac surgery and intensive care treatment. J Thorac Cardiovasc Surg 200; 120: 505-12.
7.- Dew MA, DiMartini AF, et al. Patterns and predictors of risk for depressive and anxiety-related disorders during the first three years after heart trasplantation. Psychosomatics 2000; 41:191-2.
8.- Ryding EL, Wijma B, et al. Postratumatic stress reactions alter emergent cesarean section. Acta Obstet Gynecol Scand 1997; 76: 856-61.
9.- Leslie K, Chan M, et al. Posttraumatic stress disorder in aware patients from the B-Aware trial. Anest Analg 2010; 110, 3. 823-8.
10.- Myles, P.S., Leslie, K., et al. Bispectral Index Monitoring to Prevent Awareness During Anaesthesia: The B-Aware Randomised Controlled Trial. Lancet, 2004; 363:1757-63.
11.- Horwitz R, Fenstein A. Methodologic standards and contradictory results in case-control research. Am J Med. 1979 Apr;66(4):556-64.
12.- Blake D, Weathers F, et al. The development of a clinician-administered PTSD scale. J Trauma Stress 1995; 8: 75-90.
13.- Osterman J, HopperJ, et al. Awareness during anaesthesia and the development of posttraumatic stress disorder. Gen Hosp Psychiatry 2001; 23: 198-204.
14.- Lennmarken C, Bildfords K, Enlund G, Samuelsson P, Sandin R. Victims of awareness. Acta Anaesthesiol Scand 2002; 46:229-31.
15.- Samuelsson P, Brudin L, Sandin R. Late psychological symptoms alter awareness among consecutively included surgical patients. Anaesthesiology 2007; 106: 26-32.
16.- Van der Kolk B, Fisler R. Dissociation and the fragmentary nature of traumatic memories: overview and exploratory study. J Trauma Stress 1995; 9: 505-25.
Publicado
2012-03-31
Cómo citar
Marzal Baró, J. M., García-Barquero, M. J., & Gómez-Arnau Díaz-Cañabate, J. I. (2012). Despertar Intraoperatorio y Estrés Postraumático en Anestesia. Conclusiones Extraídas del Estudio B-Aware. Revista Electrónica AnestesiaR, 4(3), 5. https://doi.org/10.30445/rear.v4i3.365
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