Falla de anestesia neuroaxial/Failed neuroaxial anesthesia

http://www.smo.edu.mx/anuncio_residentes6.htm

Malposición de catéter en anestesia epidural confirmada por tomografía computada  Epidural catheter malposition in a failed epidural anesthesia confirmed by computed tomography. Lee SJ, Kim SH, Park SY, Kim MG, Jung BI, Ok SY. Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea. Korean J Pain. 2011 Mar;24(1):44-7. doi: 10.3344/kjp.2011.24.1.44. Epub 2011 Feb 25. Abstract We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure using standardized techniques such as loss of resistance, we recommend performing the procedure under fluoroscopic guidance to improve success rate and patient safety. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049976/pdf/kjpain-24-44.pdf   ¿Por que los bloqueos epidurales no siempre funcionan?  Why Epidurals Do Not Always Work? Katherine Arendt, MD, Scott Segal, MD Department of Anesthesiology, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA Rev Obstet Gynecol. 2008;1(2):49-55. The overwhelming majority of epidural catheters placed for labor provide satisfactory analgesia. There are, however, times when the catheter is not sited within the epidural space correctly, the patient's neuraxial anatomy is problematic, or a patient's labor progresses more quickly than expected by the anesthesiologist, and the epidural block does not set up on time. In this article, the basics of neuraxial labor analgesia, the causes of its failure, and the strategies anesthesiologists employ to rescue poorly functioning catheters are reviewed. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505163/pdf/RIOG001002 _0049.pdf     Enlaces de utilidad Links: http://www.csaol.cn/img/Hypertextbook/a/c94.htm   http://www.anesthesia.utoronto.ca/edu/cme/courses/m14/Failed_Epidural  _Options_CS.htm   http://www.allaboutepidural.com/main-content/epidural-side-effects-malfunction   http://cdigital.uv.mx/bitstream/123456789/29805/1/FERMANSUAREZ JUANJORGE.pdf    Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org