Líquidos y vasopresores en prevención y manejo de hipotensión inducida por anestesia espinal durante cesárea programada en mujeres colombianas

Contenido principal del artículo

José Marrugo Marrugo
Lina Granados Vergara
Jahaira Marrugo Vergara

Resumen

Introducción: durante operación cesárea, el principal efecto colateral de la anestesia espinal es la hipotensión inducida por anestesia espinal (HIAE).
Objetivo: identificar las conductas en cuanto al uso de líquidos y vasopresores, para la prevención y manejo de la HIAE durante cesárea en mujeres sanas. Metodología: se realizó encuesta vía correo electrónico a los miembros de la Sociedad Colombiana de Anestesiología y Reanimación (SCARE) en abril de 2012 con el fin de determinar sus estrategias para prevención y manejo de la HIAE en cuanto al uso de líquidos y vasopresores. Encuesta creada por los autores y sin proceso de validación.
Resultados: 491 anestesiólogos de los 2113 (23.2%), respondieron la encuesta. El 61.7% de los participantes utilizaban solamente líquidos como estrategia de prevención de la HIAE. De ellos, el 60% lo administraba solo como precarga y el resto como cocarga. El 10.2% de todos los participantes combinaba líquidos endovenosos y vasopresores. El 3.7% utilizaba solo vasopresores y el 24.4% no utiliza ninguna de esas medidas como prevención de la HIAE. Los cristaloides fueron usados por más del 99% de los encuestados que administran líquidos rutinariamente, siendo la dosis de preferencia entre 500 y 1000 cc. Solo el 14% de los encuestados usa vasopresores en forma profiláctica, de los cuales el 53% usa etilefrina, la mayoría en forma de bolo endovenoso. La mayoría de los encuestados usa vasopresores solo en forma terapéutica, siendo preferida por el 65% la etilefrina, seguido por la efedrina, ambos administrados principalmente en forma de bolos endovenosos.
Conclusión: la etilefrina es el agente más utilizado por un grupo de anestesiólogos
colombianos pertenecientes a la SCARE, principalmente en forma de bolos endovenosos,
como medida profiláctica y terapéuticamente para la HIAE en operación cesárea. Rev.
cienc.biomed. 2014;5(2):263-271.

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