ncuesta sobre la prácticas anestésicas perioperatorias y postoperatorias para operación cesárea

Encuesta sobre la prácticas anestésicas perioperatorias y postoperatorias para operación cesárea A survey of perioperative and postoperative anesthetic practices for cesarean delivery. Aiono-Le Tagaloa L, Butwick AJ, Carvalho B. Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA. Anesthesiol Res Pract. 2009;2009:510642. Epub 2010 Feb 24. Abstract The aim of this survey was to review cesarean delivery anesthetic practices. An online survey was sent to members of the Society of Obstetric Anesthesia and Perinatology (SOAP). The mode of anesthesia, preferred neuraxial local anesthetic and opioid agents, postoperative analgesic regimens, and monitoring modalities were assessed. 384 responses from 1,081 online survey requests were received (response rate = 36%). Spinal anesthesia is most commonly used for elective cesarean delivery (85% respondents), with 90% of these respondents preferring hyperbaric bupivacaine 0.75%. 79% used intrathecal fentanyl and 77% used morphine  91 % use respiratory rate, 61% use sedation scores, and 30% use pulse oximetry to monitor for postoperative respiratory depression after administration of neuraxial opioids. Postoperative analgesic regimens include: nonsteroidal anti-inflammatory agents, acetaminophen, oxycodone, and hydrocodone by 81%, 45%, 25%, and 27% respondents respectively. The majority of respondents use spinal anesthesia and neuraxial opioids for cesarean delivery anesthesia. There is marked variability in practices for monitoring respiratory depression postdelivery and for providing postoperative analgesia. These results may not be indicative of overall practice in the United States due to the select group of anesthesiologists surveyed and the low response rate.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915619/pdf/ARP2009-510642.pdf Bloqueo subaracnoideo en operación cesárea en pre eclampsia severa Subarachnoid block for caesarean section in severe preeclampsia Chaudhary S, Salhotra R.. J Anaesth Clin Pharmacol [serial online] 2011 [cited 2011 Jun 3];27:169-73. Pregnancy-induced hypertension constitutes a major cause of morbidity and mortality in developing nations and it complicates about 6-8% of pregnancies. Severe preeclampsia poses a dilemma for the anesthesiologist especially in emergency situations where caesarean deliveries are planned for uninvestigated or partially investigated parturients. This article is aimed to review the literature with regards to the type of anesthesia for such situations. A thorough search of literature was conducted on PubMed, EMBASE, and Google to retrieve the articles. Studies on parturients with severe preeclampsia, undergoing caesarean section, were included in this article. There is growing evidence to support the use of subarachnoid block in such situations when the platelet counts are >80,000 mm−3 . Better hemodynamic stability with the use of low-dose local anesthetic along with additives and better neonatal outcomes has been found with the use of subarachnoid block when compared to general anesthesia. Keywords: Pregnancy-induced hypertension, regional anesthesia or general anesthesia for caesarean deliveries, severe preeclampsia, subarachnoid block for caesarean section, thrombocytopenia and regional anesthesia. http://www.joacp.org/text.asp?2011/27/2/169/81821

Atentamente Dr. Benito Cortes-Blanco  Anestesiología y Medicina del Dolor www.anestesia-dolor.org