Tatuajes y varios aretes: consideraciones anestesiológicas
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Tattooing and various piercing: anaesthetic considerations.
Département d'Anesthésie Réanimation Chirurgicale, Hospitalier Paris Sud, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, CLAMART, Cedex 92141, France. frederic.mercier@abc.aphp.fr
Abstract
PURPOSE OF REVIEW: Body art is increasing since the 1990s. Anaesthesiologists would be more and more confronted to patient with tattooing or piercing, or both. This review discusses the anaesthetic potential risks and complications observed with tattooing and piercing, their management and prevention. RECENT FINDINGS: Airway management during anaesthesia is of particular interest with oral jewelry. Patients often refuse to remove their piercing for fear of tract closure. There are no serious complications reported after epidural puncture through a tattoo, although any long-term consequence cannot be discarded yet. Even theoretical concerns are more and more debated. SUMMARY: Oral and nasal piercing is of particular concern because of the risks of swallowing and aspiration. Consequently, patients should be advised to remove piercing before anaesthesia. Emergency situations are especially risky and anaesthesiologists should be aware of the piercing removal techniques. In case of piercing loss, radiographies and fiberoptic endoscopy of the upper airways and digestive tracts should be performed to eliminate aspiration or swallowing of the foreign body. Epidurals should not be denied to parturients with lumbar tattooing. However, it seems still prudent to avoid direct tattoo puncture or when unavoidable, to nick the skin prior to inserting the needle through the tattoo
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| Anestesia neuroaxial a través de tatuajes: ¿Es seguro puncionar el dragón? |
Neuraxial Anesthesia Through Tattoos: Is it Safe Puncturing The Dragon?
Barbara G. Jericho M.D.
Department of Anesthesiology
University of Illinois Medical Center at Chicago
The Internet Journal of Anesthesiology. 2009 Volume 20 Number
Tattoos have become increasingly popular. In the United States, more than 45 million people have tattoos1. Almost 50% of all tattoos are being done on women2. I have seen an increasing number of women with lumbar midline tattoos requesting labor epidurals. Neuraxial anesthesia in the lumbar region with a tattoo brings up the concern of introducing the pigment into the central nervous system. Many of us have surely asked ourselves at one time or another "Should I place the spinal or epidural needle through the tattoo or not through the tattoo if possible?". As I have found, the practice among anesthesiologists varies. A survey in England revealed that 65% of consultant anesthetists with obstetric sessions place the needle through the tattoo during spinal or epidural anesthesia.http://www.ispub.com/journal/the_internet_journal_of_anesthesiology/volume_20_number_1/article/neuraxial_anesthesia_through_tattoos_is_it_safe_puncturing_the_dragon.html
Anestesia
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| Anestesia epidural en tres parturientas con tatuajes lumbares: revisión de posibles implicaciones |
Epidural anesthesia in three parturients with lumbar tattoos: a review of possible implications.
Douglas MJ, Swenerton JE.
Department of Anesthesia, BC Women's Hospital, Vancouver, British Columbia, Canada. jdouglas@cw.bc.ca
Can J Anaesth. 2002 Dec;49(10):1057-60.
Abstract
PURPOSE: To discuss the possible ramifications of neuraxial analgesia and anesthesia in women with tattoos involving their midline lumbar area. CLINICAL FINDINGS: Recently the authors have received requests for epidural anesthesia in three women with tattoos over the midline of their lumbar spine. In one patient the tattoo covered her entire back. In the other two, it was possible to locate a lumbar interspace that did not have tattoo pigment in the overlying skin. All three women received uneventful epidural analgesia. A Medline and EMBASE search for relevant publications using the keywords: epidural, spinal, tattoos, tattooing, complications did not find any reports of complications from inserting a needle through a tattoo. As none were found, the literature on tattoos and on coring with neuraxial anesthesia was reviewed to see if neuraxial anesthesia might be problematic if the needle passed through the tattoo. Coring is a complication of neuraxial anesthesia that may lead to epidermoid tumours in the subarachnoid space. Theoretically, a pigment-containing tissue core from a tattoo could be deposited into the epidural, subdural or subarachnoid spaces, leading to later neurological complications.
CONCLUSIONS: There is no information in the literature about possible risks from inserting needles through tattoos during the performance of neuraxial anesthesia. This report discusses the possible implications.http://www.springerlink.com/content/el0218110gm03227/fulltext.pdf
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| Carta al editor sobre tatuajes en anestesia |
Susana Carrada Pérez
Anestesia en México 2008;20:106-108
Deseo llamar su atención sobre los tatuajes y la anestesia subaracnoidea con un caso reciente. Una paciente de 35 años acude para cirugía ginecológica, ASA 1, sin mayores antecedentes que ingesta frecuente de alcohol, marihuana y a veces cocaína. Sus exámenes de laboratorio fueron normales y un panel toxicológico de 24 horas previas fue negativo. De acuerdo al tipo de cirugía programada, le realicé un bloqueo subaracnoideo con 12 mg de bupivacaína 0.5% pesada y 150 μg de morfina sin conservador para producir analgesia postoperatoria. La evolución de esta paciente fue sin complicaciones y se dio alta domiciliaria 36 horas después de la cirugía. Como puede observar en la imagen que le envío, la paciente tiene un gran tatuaje lumbar que apenas me dio oportunidad de evitarlo al introducir la aguja raquídea tipo Whitacre 27con la supuesta idea de no introducir el colorante del tatuaje en el espacio subaracnoideo. Primero inserté una aguja hipodérmica y a través de ella coloqué la aguja espinal hasta el espacio subaracnoideo, todo esto con la idea de evitar acarrear al espacio subaracnoideo el colorante del tatuaje que pudiera estar en el tejido subdérmico, ya que evité el paso a través de la figura tatuada, como se ve en la fotografía.http://www.anestesiaenmexico.org/RAM9/RAM2008-20-2/012.pdf
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| Consideraciones anestesiológicas en una paciente con un arete lingual y una solución segura |
Anesthetic considerations of a patient with a tongue piercing, and a safe solution.
Brown DC
Anesthesiology. 2000 Jul;93(1):307-8.
To the Editor:-A young woman presented for emergency dilation and curettage and requested general anesthesia. She recently had her tongue pierced and currently had a large, metal, barbell-shaped bolt in her tongue. While discussing the placement of the device, the patient relayed anecdotal stories of people swallowing the lower or upper portion in their sleep, even though the bolt was believed to be tightly screwed together. After the anesthetic risks of the tongue piercing
were explained to the patient,' she was reluctant to remove the device for fear of having to get her tongue repierced, should the hole close.http://journals.lww.com/anesthesiology/Citation/2000/07000/Anesthetic_Considerations_of_a_Patient_with_a.64.aspx
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Complicaciones de aretes en la lengua. Reporte de un caso y revisión de la literatura
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A complication of tongue piercing. A case report and review of the literature.
Theodossy T.
Source
Oral and Maxillofacial Surgery, Maxillofacial Unit, University College London Hospitals NHS Trust, Mortimer Market, WC1E 6AU. tamertheodossy@hotmail.com
Br Dent J. 2003 May 24;194(10):551-2.
Abstract
Several complications of oral piercing have been reported, some of which are life threatening. A case report on tongue piercing is presented where the ventral surface of the tongue healed over the barbell requiring surgical exposure.
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