Lidocaína - fentanyl para anestesia analgesia peridural en cesáreas
Abstract
En quince pacientes A.S.A. I y I I , se evalúa las ventajas que tiene la adición de un narcótico, en este caso el fentanyl 1100 ug), a la solución del anestésico local
(lidocaina al 2 o/o con epinefrina 1:200.000(13 ce).
La presión arterial sistólica desciende en un 10 o/o del valor inicial a los 5 minutos retornando a los valores básales aproximadamente a los quince minutos. La
frecuencia cardíaca sufre pocas variaciones, sin significación clínica ni estadística.
El APGAR del recién nacido tiene una media de (8.5) al primer minuto, y de (9.8) a los cinco minutos. No se reportó complicaciones inherentes a la técnica anestésica durante el seguimiento que se realizó de los niños a las 12 y 24 horas.
Ninguna de las pacientes presentó depresión respiratoria; disconfort, náusea y/o vómito durante la manipulación uterina.
La anelgesia fue buena en todas las pacientes con una duración promedio de (3.7 horas), y un rango que fue de (3 - 5 horas).
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
References
1. ALAHÜTA S.. KA \ (iAS - SARELAT.. HOLLMEN A.I., et. al. Visceral painjí during cesarean section under spinal and epidural anaesthesia with bupivacaine. Acta anaesthcsiologica scandinavica. 1990: 34 95-98.
2.I, IKS. fentan\ given epidurally for postoperativc analgesia. Anesthesiology. 1984; 61: 466-469.
3.ORCE V.. \. Morfina por vía epidural en la analgesia post-eesárea: aspecto.s perinatológico.s. Rev. ,4rq. de Anest. 1987; 45(2); 83-87.
4..IONES C . l'AlLn . l . . . ELTON R. A . . et. al. A comparison of bupivacaine and bupivacaine-fentanyl in continuos extradural analgesia in labour. Br. .1 of anaesth. 1989: 63:254-259.
5. PAECH M. !.. WKSTMORE M. D . SPEIRS H.M. A doubicbiind coni|)arison of epidural bupivacaine an bupivacaine-fentanyl for casarean section. Anaesthesia and Intensive Carc 1990; 18; 22-30.
6. NALLTY J.S.. DATTA S.. OSTHEIMER C.W.. et. al. Epidural fentanyl for post-ce.sarean delivery pain management. Anesthesiology. 1985:63:694-698.
7. SIINIDER .S.M. peridural opioids and local anesthetics for pain management in ob.stetrics. Annual refresher course lectures. 1992; 244:5.
8. BROMAGE P.K Epidural analgesia Philadelphia: Saunders. 1978:pp. 137-144
9. BAHAR M , Me AULEY D.M.. DUNDEE J.W. an alternativc visual analogiie scale. (correspondencia). Anaesthesia. 1982; 37:342.
10. BROWN .1 Prevención y alivio del dolor dcspués de cesárea. Clínicas de Anestesiología de Norteamérica. 1990; 8. Cap. 155: p. 163.
11. NOBLE DW.. MORRISON L.M.. BROCKWAY M.S. adrenaline. feiitanvl or adrenaline and fentanyl as adjucts to bupivacaine for extradural anaesthesia in eleetive cesarean section. Br. J . of anaesth. 1991:66:645-690.
12. C.AP0GNA G., CELLENO D., CONSTANTINO P., et. al. The ddition of bicarbonatc improvcs the quality of intraoperative analgesia of lidocaine fentanyl epidural anestehesia for cesarean section. Regional Anestehsia. 1992; 17:32.
13.AkERMAN WE , JUNEJA MM., COLCLOUGH GW.: A comparison of epidural fentanyl, buprenorphine and butorphanol for the manegement of post cesarean section pain. Anesthesiology. 1988; 39;A 401.
14.COLBURN N., MANDELE G., RUDY T.: Epidural fentanyl for post-vaginal delivery pain. .Anesthesiology. 1990: 73:.A986.
15. MADEJ TH., STRUNIN L . : Comparison of epidural fentanyl with sufentanyl. Anaesthesia. 1987; 42:1156.
16. MALIN0W AM., MOKRISKY BL , NOMURA MK.. KAUMAN MA., SNELL JA., SHARP GD., HOWARD RA. Effect of epinephinc on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation. Anesthesiology. 1990; 73(3):381-385.
17. YU PYH.. GAMBLING DR., McMORLAND GH.; A comparative study of patient controlled epidural fentanyl and single dose epidural morphine for post-caesarean section analgesia. Can. .|. Anaesth. 1989; 36:S55.
18. AllU.IA BR.. STRUNIN L . : Respiratory effects of epidural fentanyl. Anaesthesia. 1985; 40:949.
19. BIRNB.ACH DJ , JOHNSON MD.. ARCARIO T.. ET A L . l : Effect of diluent volumen on analgesia produced bv epidrual fentanyl. Anesth Analg. 1989; 68:808.
20. GOURLAY GK., KOWALSKY SR.. PLUMMER J L . , ET AL.: Fentanyl blood concentration-analgesic response realtionship in the treatment of postoperativc pain. Anesth Analg. 1988; 67:329.
21. NEGRE I . , GUENERON J . ECOFFEY C , et. al. Ventilatory respose to carbón dioxide after IM and epidural fentanyl. Anesthesia and analgesia 1987;66:707-710.
22. GANT N.F., WALLACE D H. Anaesthetic management in pregnancy induced hipertensión. Clinics in anaesthesiology. 1986; 4:321-350.
23. WRITE D.R. Epidural morphine for post cesarean analgesia. Cañaddian Journal of anaesthesia. 1990; 37:608-612.
24. ELCHES R C , SANDLER AN., DALEY MD.: Respiratory depression from spinal opioids. Can. J . Anaesth. 1989; 36:165.
25. COÜSINS MJ , BRIDENBAUGH OP.: Dolor agudo y crónico, uso de los opiáceos por vía medular. Bloqueos Nerviosos en Anestesia Clínica y Tratamiento del Dolor. Ed. Doyma, Barcelona. 1991; 973-1108.
26. LAM AM., KNILL RL., THOMPSON WR., ET AL.: Epidural fentanyl does not cause delayed respiratory depression. Can.J. Anaesth. 1983;30:S78.
27. ELLIS DJ., MILLAR WL., REISNER LS.: A randomized doubleblind comparison of epidural versus intravenous fentanyl infusión for analgesia afther cesarean section. Anesthesiology. 1990; 72: 981.
28. MIR.ALLES E . , ALONSO B.: Efectos indeseables de la administración de opiáceos por vía espinal. Rev. Esp. Anestesiol. Reanim. 1992;39:187-190.
29. CAPOGNA G., CELLENO D.. TOMASSETTI M. Maternal analgesia and neonatal effects of epidrual fentanyl for cesarean section. Regional anesthesia. 1989; 14:282-287.
30. COUSlNS M.L. MATHER L . E . Intrathecal and epidural administration of opioids. Anesthesiology . 1984; 61:276-310.
31. DIAKAKI C , DEFTEREVOU Z., KATSIARI E . , et al. Combined intrathecal fentanyl and epidural lignocaine for cesarean section in high-risk pregnancy: a preliminary study. (ABSTRACTS). 1991; 17: p.33.
32. BROMAGE P.R.. MOHAMED N., et. al. Epinephrine and fentanyl as adjuvants to 0.5 o/o Bupivacaine for epidural analgesia. Regional anesthesia 1989; 14: 189-192.
33. YEAGER M.P.. GLASS D.D.. NEFF R.F., et. al. Epidural anesthesia and analgesia in high-risk surgical patient. Anesthesiology. 1987; 66:729-736.
34. BENLABED M. DREIZZEN E . , E C O F EY C , etal. Neonatal pattems of breathing after cesarean section with or without epidural fentanyl. Anesthesiology .1990;73:110-113.
2.I, IKS. fentan\ given epidurally for postoperativc analgesia. Anesthesiology. 1984; 61: 466-469.
3.ORCE V.. \. Morfina por vía epidural en la analgesia post-eesárea: aspecto.s perinatológico.s. Rev. ,4rq. de Anest. 1987; 45(2); 83-87.
4..IONES C . l'AlLn . l . . . ELTON R. A . . et. al. A comparison of bupivacaine and bupivacaine-fentanyl in continuos extradural analgesia in labour. Br. .1 of anaesth. 1989: 63:254-259.
5. PAECH M. !.. WKSTMORE M. D . SPEIRS H.M. A doubicbiind coni|)arison of epidural bupivacaine an bupivacaine-fentanyl for casarean section. Anaesthesia and Intensive Carc 1990; 18; 22-30.
6. NALLTY J.S.. DATTA S.. OSTHEIMER C.W.. et. al. Epidural fentanyl for post-ce.sarean delivery pain management. Anesthesiology. 1985:63:694-698.
7. SIINIDER .S.M. peridural opioids and local anesthetics for pain management in ob.stetrics. Annual refresher course lectures. 1992; 244:5.
8. BROMAGE P.K Epidural analgesia Philadelphia: Saunders. 1978:pp. 137-144
9. BAHAR M , Me AULEY D.M.. DUNDEE J.W. an alternativc visual analogiie scale. (correspondencia). Anaesthesia. 1982; 37:342.
10. BROWN .1 Prevención y alivio del dolor dcspués de cesárea. Clínicas de Anestesiología de Norteamérica. 1990; 8. Cap. 155: p. 163.
11. NOBLE DW.. MORRISON L.M.. BROCKWAY M.S. adrenaline. feiitanvl or adrenaline and fentanyl as adjucts to bupivacaine for extradural anaesthesia in eleetive cesarean section. Br. J . of anaesth. 1991:66:645-690.
12. C.AP0GNA G., CELLENO D., CONSTANTINO P., et. al. The ddition of bicarbonatc improvcs the quality of intraoperative analgesia of lidocaine fentanyl epidural anestehesia for cesarean section. Regional Anestehsia. 1992; 17:32.
13.AkERMAN WE , JUNEJA MM., COLCLOUGH GW.: A comparison of epidural fentanyl, buprenorphine and butorphanol for the manegement of post cesarean section pain. Anesthesiology. 1988; 39;A 401.
14.COLBURN N., MANDELE G., RUDY T.: Epidural fentanyl for post-vaginal delivery pain. .Anesthesiology. 1990: 73:.A986.
15. MADEJ TH., STRUNIN L . : Comparison of epidural fentanyl with sufentanyl. Anaesthesia. 1987; 42:1156.
16. MALIN0W AM., MOKRISKY BL , NOMURA MK.. KAUMAN MA., SNELL JA., SHARP GD., HOWARD RA. Effect of epinephinc on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation. Anesthesiology. 1990; 73(3):381-385.
17. YU PYH.. GAMBLING DR., McMORLAND GH.; A comparative study of patient controlled epidural fentanyl and single dose epidural morphine for post-caesarean section analgesia. Can. .|. Anaesth. 1989; 36:S55.
18. AllU.IA BR.. STRUNIN L . : Respiratory effects of epidural fentanyl. Anaesthesia. 1985; 40:949.
19. BIRNB.ACH DJ , JOHNSON MD.. ARCARIO T.. ET A L . l : Effect of diluent volumen on analgesia produced bv epidrual fentanyl. Anesth Analg. 1989; 68:808.
20. GOURLAY GK., KOWALSKY SR.. PLUMMER J L . , ET AL.: Fentanyl blood concentration-analgesic response realtionship in the treatment of postoperativc pain. Anesth Analg. 1988; 67:329.
21. NEGRE I . , GUENERON J . ECOFFEY C , et. al. Ventilatory respose to carbón dioxide after IM and epidural fentanyl. Anesthesia and analgesia 1987;66:707-710.
22. GANT N.F., WALLACE D H. Anaesthetic management in pregnancy induced hipertensión. Clinics in anaesthesiology. 1986; 4:321-350.
23. WRITE D.R. Epidural morphine for post cesarean analgesia. Cañaddian Journal of anaesthesia. 1990; 37:608-612.
24. ELCHES R C , SANDLER AN., DALEY MD.: Respiratory depression from spinal opioids. Can. J . Anaesth. 1989; 36:165.
25. COÜSINS MJ , BRIDENBAUGH OP.: Dolor agudo y crónico, uso de los opiáceos por vía medular. Bloqueos Nerviosos en Anestesia Clínica y Tratamiento del Dolor. Ed. Doyma, Barcelona. 1991; 973-1108.
26. LAM AM., KNILL RL., THOMPSON WR., ET AL.: Epidural fentanyl does not cause delayed respiratory depression. Can.J. Anaesth. 1983;30:S78.
27. ELLIS DJ., MILLAR WL., REISNER LS.: A randomized doubleblind comparison of epidural versus intravenous fentanyl infusión for analgesia afther cesarean section. Anesthesiology. 1990; 72: 981.
28. MIR.ALLES E . , ALONSO B.: Efectos indeseables de la administración de opiáceos por vía espinal. Rev. Esp. Anestesiol. Reanim. 1992;39:187-190.
29. CAPOGNA G., CELLENO D.. TOMASSETTI M. Maternal analgesia and neonatal effects of epidrual fentanyl for cesarean section. Regional anesthesia. 1989; 14:282-287.
30. COUSlNS M.L. MATHER L . E . Intrathecal and epidural administration of opioids. Anesthesiology . 1984; 61:276-310.
31. DIAKAKI C , DEFTEREVOU Z., KATSIARI E . , et al. Combined intrathecal fentanyl and epidural lignocaine for cesarean section in high-risk pregnancy: a preliminary study. (ABSTRACTS). 1991; 17: p.33.
32. BROMAGE P.R.. MOHAMED N., et. al. Epinephrine and fentanyl as adjuvants to 0.5 o/o Bupivacaine for epidural analgesia. Regional anesthesia 1989; 14: 189-192.
33. YEAGER M.P.. GLASS D.D.. NEFF R.F., et. al. Epidural anesthesia and analgesia in high-risk surgical patient. Anesthesiology. 1987; 66:729-736.
34. BENLABED M. DREIZZEN E . , E C O F EY C , etal. Neonatal pattems of breathing after cesarean section with or without epidural fentanyl. Anesthesiology .1990;73:110-113.
Downloads
Published
2017-06-16
How to Cite
1.
Montalvo A, De La Roche R, Quezada L, Pareja M, Vallejo A. Lidocaína - fentanyl para anestesia analgesia peridural en cesáreas. Rev Fac Cien Med (Quito) [Internet]. 2017 Jun. 16 [cited 2024 Dec. 19];19(1-4):24-8. Available from: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/772
Issue
Section
ARTÍCULOS ORIGINALES
