Aunque el uso de clonidina espinal en pacientes obstétricas aún es controversial, hay suficiente información para considerarlo como un adyuvante seguro para mejorar la analgesia del trabajo de parto, la anestesia espinal para la cesárea, y también para favorecer analgesia espinal postoperatoria después del parto quirúrgico. Usando dosis recomendadas, los efectos secundarios habituales de clonidina subaracnoidea son hipotensión moderada, arritmias fetales no perjudiciales, y sedación moderada en la madre.
Although spinal clonidine use in obstetrics patients still controversial, there is enough information to consider it as a safe adjuvant to enhance spinal labour analgesia and to improve spinal anaesthesia for caesarean section, and also to augment spinal postoperative anaesthesia after surgical delivery. Using recommended doses, the usual side effects of subarachnoid clonidine are moderate hypotension, non harm fetal arrhythmias, and moderate mother sedation.
Embora o uso de clonidina subaracnóidea em pacientes de obstetrícia, ainda é controverso, não há informação suficiente para considerá-lo como um adjuvante seguro para aumentar a analgesia de parto e melhorar a raquianestesia para cesariana, e também para aumentar a anestesia espinhal pós-operatório após o parto cirúrgico. Usando as doses recomendadas, os efeitos colaterais usuais de clonidina subaracnóidea são hipotensão moderada, bradicardia fetal não prejudicar, e sedação mãe moderado.
Clonidina subaracnoidea en Obstetricia
Clonidina intratecal como adyuvante en analgesia obstétrica, anestesia raquídea, y analgesia en cesárea.
Intrathecal Clonidine as Adjuvant for Labor Analgesia, Spinal Anesthesia, and Postoperative Analgesia in Caesarean Section
Victor M. Whizar-Lugo
J Anesth Crit Care Open Access 2014, 1(1): 00005
http://medcraveonline.com/JACCOA/JACCOA-01-00005.pdf
Clonidina espinal con bupivacaína hiperbárica administrada como mezcla y secuencial en cesárea. Estudio randomizado y controlado
Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study.
Sachan P, Kumar N, Sharma J.
Indian J Anaesth. 2014 May;58(3):287-92. doi: 10.4103/0019-5049.135039.
http://www.ijaweb.org/article.asp?issn=0019-5049;year=2014;volume=58;issue=3;spage=287;epage=292;aulast=Sachan
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=3;spage=287;epage=292;aulast=Sachan;type=2
Comparación de la analgesia postoperatoria de la clonidina y fentanil intratecales adicionados a bupivacaína en pacientes de cesárea. Estudio prospectivo, randomizado y doble ciego
Comparison of postoperative analgesic effect of intrathecal clonidine and fentanyl added to bupivacaine in patients undergoing cesarean section: a prospective randomized double-blind study.
Khezri MB1, Rezaei M1, Delkhosh Reihany M1, Haji Seid Javadi E2.
Pain Res Treat. 2014;2014:513628. doi: 10.1155/2014/513628. Epub 2014 Feb 4.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932201/pdf/PRT2014-513628.pdf
El efecto de agregar clonidina intratecal a bupivacaína hiperbárica sobre el dolor postoperatorio en cesárea. Estudio controlado randomizado
The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section: A randomized control trial.
Singh R1, Gupta D, Jain A.
Saudi J Anaesth. 2013 Jul;7(3):283-90. doi: 10.4103/1658-354X.115360.
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2013;volume=7;issue=3;spage=283;epage=290;aulast=Singh;type=2
Raquia en cesárea electiva. Diferentes dosis de bupivacaína hiperbárica asociada con morfina y clonidina
Spinal anesthesia for elective ceasarean section: use of different doses of hyperbaric bupivacaine associated with morphine and clonidine.
Braga Ade F1, Frias JA, Braga FS, Pereira RI, Titotto SM.
Acta Cir Bras. 2013 Jan;28(1):26-32.
http://www.scielo.br/pdf/acb/v28n1/v28n1a05.pdf
Prevención de la hipotensión y prolongación de analgesia postoperataoria en cesárea urgente. Estudio randomizado con clonidina intratecal
Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine.
Bajwa SJ1, Bajwa SK, Kaur J, Singh A, Singh A, Parmar SS.
Int J Crit Illn Inj Sci. 2012 May;2(2):63-9. doi: 10.4103/2229-5151.97269.
http://www.ijciis.org/downloadpdf.asp?issn=2229-5151;year=2012;volume=2;issue=2;spage=63;epage=69;aulast=Bajwa;type=2
http://www.ijciis.org/temp/IntJCritIllnInjSci2263-470679_130427.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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