Información del artículo
Resumen
Los autores aportan una raquianestesia con 10 μg de sufentanilo, efectuada al término del trabajo de parto para el expulsivo de un niño en presentación de nalgas y de dos gemelos, en parturientas cuyo estado de agitación hacía sospechar un expulsivo por vía baja hipotético o difícil. El efecto antiálgico se instaló en 5 min y fue posible el parto por vía vaginal. La utilidadde la técnica es discutida en casos de situaciones difíciles al término del trabajo de parto, en el caso de que una analgesia peridural no se hubiera instaurado.
Summary
The authors report 2 cases of spinal analgesia with 10ug of Sufentanil at the end of second stage of labour, in a breech delivery and vaginal twin delivery. In both cases maternal agitation could have made foetal extraction difficult. The analgesic effect started 5 minutes after administration, and vaginal delivery was possible. The usefulness of this technique for analgesia during the second stage of labour, when epidural analgesia has not been used, is discussed.
El Texto completo está disponible en PDF
Bibliografía
[1.]
J. Mailan.
Bloqueos espinales.
Tratado de anestesiología y reanimación en obstetricia. Princi-pios fundamentales y bases de aplicación clínica, pp. 259-308
[2.]
A. Miranda.
Analgoanestesia en el parto vaginal normal.
Tratado de anestesiología y reanimación en obstetricia. Principios fundamentales y bases de aplicación clínica, pp. 383-445
[3.]
J.A. Thorp, D.H. Hu, R.M. Albin, J. McNitt, B.A. Meyer, G.R. Cohen, et al.
The effect of intrapartum epidural analgesia on nulliparous labor: A randomised, controlled, prospective trial.
Am J Obstet Gynecol, 169 (1993), pp. 851-858
[4.]
A. Miranda.
Protocolos asistenciales en anestesia obstétrica.
[5.]
A.P. Stoddart, K.E. Nicholson, P.A. Popham.
Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery.
Anaesthesia, 49 (1994), pp. 1087-1090
[6.]
R. Depp.
Analgesia and anesthesia for forceps delibery.
Principles and practice of obstetric analgesic and anesthesia, 2, pp. 918-935
[7.]
J. Mallafré, L. Miranda.
Parto gemelar o múltiple.
Tratado de anestesiología y reanimación en obstetricia. Principios fundamentales y bases de aplicación clínica, pp. 473-490
[8.]
J.S. Crawford, J.B. Weaver.
Anesthetic management of twin and breech deliveries.
Clin Obstet Gynecol, 2 (1982), pp. 291-296
[9.]
A.M. Malinow, G.W. Ostheimer.
Anesthesia for the high risk parturient.
Obstet Gynecol, 69 (1987), pp. 951-964
[10.]
G.H. McMorland, S.B. Effer.
Breech presentation, mal presentation, multiple gestation.
Anesthesic and obstetric management of high risk pregnancy, pp. 78-88
[11.]
B.L. Koffel.
Abnormal presentations and multiple gestation.
Pain relief and anesthesia in obstetrics, 43 (1996), pp. 505-513
[12.]
Y. Darbois, D. Sfoggia, M. Henry, D. Vauthier, J. Seebacher.
Abnormal presentation and multiple gestation.
Pain relief and anesthesia in obstetrics, 43 (1996), pp. 513-517
[13.]
S.E. Cohen, S. Tan, G.A. Albright, J. Halpern.
Epidural fentanyl-bupivacaine mixture for obstetric analgesic.
Anesthesiology, 67 (1987), pp. 403-407
[15.]
E. Abouleish.
Regional analgesia for labor and vaginal birth.
Handbook of obstetric analgesia and anesthesia, 7 (1992), pp. 44-63
[16.]
J.S. McDonald, D.A. Mandalfino.
Subaracnoid Block.
Principles and practice of obstetric analgesia, 2, pp. 471-496
[17.]
W.M. Grieco, M.C. Norris, B.L. Leighton, V.A. Arkoosh, H.J. Huffnagle, J.E. Honet, et al.
Intrathecal sufentanil labor analgesia: the effects of adding morphine or epinephrine.
Anest Analg, 77 (1993), pp. 1149-1154
[18.]
R.E. Collis, M.L. Baxandall, I.D. Srikantharajah, G. Edge, M.Y. Ka-dim, B.M. Morgan.
Combined spinal epidural (CSE) analgesia: technique, management, and outcome of 300 mothers.
Int J Obstet Anesth, 3 (1994), pp. 75-81
[19.]
B.M. Morgan, M.Y. Kadim.
Mobile regional analgesia in labour.
Br J Obstet Gynaecol, 101 (1994), pp. 839-841
[20.]
B.M. Morgan.
Combined spinal and epidural blockade for analgesia in labour.
Eur J Obstet Gynecol Reprod Biol, 59 (1995), pp. S59-S60
[21.]
N. Rawal.
Combined spinal-epidural anesthesia.
Pain relief and anesthesia in obstetrics, 35 (1996), pp. 413-426
[22.]
A. Van Elstraete, T.H. Lebrun, F. Pastureau, I. Guerrieri, R. Limol.
Rachianesthésie aux morphiniques en fin de travail pour expulsions par voie baisse potentiellement difficiles.
J Gynecol Obstet Biol Reprod, 29 (2000), pp. 202-205
[23.]
C.J. Hutchins.
Spinal analgesia for instrumental delivery.
A comparison with pudeudal nerve block Anesthesia, 35 (1980), pp. 376-377
[24.]
P. Brownridge.
Spinal anesthesia revisited: an evaluation of subarachnoid block in obstetrics.
Anesth Intens Care, 12 (1984), pp. 334-342
[25.]
B. Glosten.
Local anesthetic techniques.
pp. 354-378
[26.]
B.L. Hartwell, L.S. Aglio, M.A. Hauch, S. Datta.
Vertebral column lenght and spread of hyperbaric subarachnoid bupivacaine in the tern parturient.
Regional Anesth, 16 (1991), pp. 17-19
[27.]
J.S. Naulty, L. Hertwig, S. Datta, J.B. Weiss, G.W. Ostheimer.
Influence of local anesthetic solution on postdural puncture headache [resumen].
Anaesthesiology, 63 (1985), pp. 454
[28.]
M. Cesarini, R. Torrielli, F. Lahaye, J.M. Mene, C. Cabiro.
Sprotte needle for intrathecal anaesthesia for caesarean section: incidence of postdural puncture headache.
Anaesthesia, 45 (1990), pp. 656-658
[29.]
T. Hucbay, J.M. Skerman, R.J. Hurley, D.H. Lambert.
Sensory analgesia for vaginal deliveries: a preliminary report of continous spinal anaesthesia with a 32-gauge catheter.
Regional Anesth, 16 (1991), pp. 150-153
[30.]
M.L. Rigler, K. Drasner, T.C. Krejcie, S.J. Yelich, F.T. Scholnick, J. De Fontes, et al.
Canda Equina Syndrome After Continuos Spinal Anesthesia.
Anesth Analg, 72 (1991), pp. 275-281
[31.]
S. McHale, V. Mitchell, S. Howsam, F. Carli.
Continuous subarachnoid infusion of 0,125% bupivacaine for analgesia during labour.
Br J Anaesth, 69 (1992), pp. 634-636
[32.]
C.H. Leicht, G.S. Vasdev.
Microcatheter continuous spinal anaesthesia with 1 and 2% lidocaine: an in vitro assessment of the potential for neurologic injury with a 24G catheter [resumen].
Anesthesiology, 79 (1993), pp. 1010
[33.]
J.H. Skerman, R.J. Hurley, D.H. Lambert.
Continuos spinal anesthesia.
Pain relief anesthesia in obstetrics, (1996), pp. 406-412
[34.]
A. Miranda.
Opiáceos espinales en obstetricia.
Revisión Rev Esp Anestesiol Reanim, 42 (1995), pp. 369-377
[35.]
B.L. Leighton, C.A. De Simone, M.C. Norris.
Intrathecal narcotics for labor revisited: the combination of fenatyl and morphine intrathecally provides rapid onset of profound, prolonged, analgesia.
Anesth Analg, 69 (1989), pp. 122-127
[36.]
J. Flórez.
Fármacos analgésicos opioides.
Farmacología humana, 3, pp. 435-452
[37.]
J. Flórez, E. Reig.
Farmacoterapia antiálgica.
[38.]
J. Scholz, M. Steinfanth, M. Schulz.
Clinical pharmacokine-tics of alfentanil, fentanyl and sufentanil.
Clin Pharmacoki-net, 31 (1996), pp. 75-92
[39.]
M.A. Hurlé.
Fármacos anestésicos generales.
Farmacología humana, 3, pp. 477-488
[40.]
J.S. Naulty, D. Barnes, R. Becker, A. Pate.
Continuous suba-rachnoid sufentanil for labor analgesia [resumen].
Anaest-hesiology, 73 (1990), pp. 964
[41.]
J.E. Honet, V.A. Arkoosh, M.C. Norris, H.J. Huffnagle, N.S. Silver-man, B.L. Leighton.
Comparison Among Intrathecal Fen-tanyl, Meperidinc, and Sufentanil for Labor Analgesia.
Anaesth Analg, 75 (1992), pp. 734-739
[42.]
S.E. Cohen, C.M. Cherry, R.H. Holbrook, Y.Y. El-Sayed.
Intrat-hecal sufentanil for labor analgesia.
Sensory changes, side effects, and fetal heart rate changes. Anesth Analg, 77 (1993), pp. 1155-1160
[43.]
F.J. Mercier, X. Paqueron.
Spinal analgesia for labor.
Can Anesthesiol, 44 (1996), pp. 173-179
[44.]
M. El-Naggar, H. Fagar, R.K. Kartha.
The use of 28G continuous spinal catheters to administer fentanyl to manage labor pain: a dose finding study [resumen].
Anaesthesiology, 73 (1990), pp. 970
[45.]
B.E. Marshall, D.E. Longnecker.
Anestésicos generales.
9, pp. 327-351
[46.]
T. Reisine, G. Pasternak.
Analgésicos opioides y sus antagonistas.
9, pp. 557-593
[47.]
M.C. Norris, S. Boreen, B.L. Leighton, D. Mingey, H. Kent.
In-trathecal meperidine for labor analgesia [resumen].
Anaest-hesiology, 73 (1990), pp. 983
[48.]
E. Aboufeish, N. Rawal, J. Shaw, T. Lorenz, M.N. Rashad.
In-trathecal Morphine 0,2 mg versus Epidural Bupivacaine 0,125% or their Combination: Effects of Parturients.
Anest-hesiology, 74 (1991), pp. 711-716
[49.]
H.J. McQuay, A.F. Sullivan, K. Smallman, A.H. Dickenson.
Intrathecal opioids, potencylipophilicity..
Pain, 36 (1989), pp. 111-115
[50.]
F.P. Boersma, T.F. Meert, M. Vercauteren.
Spinal sufentanil in rats: part I: epidural versus intrathecal sufentanil and mor phine.
Acta Anesthesiol Scand, 36 (1992), pp. 187-192
[51.]
J.P. Ducey, K.G. Knape, J. Talbot.
Intrathecal narcotics for labor cause hypotensión [resumen].
Anaesthesiology, 77 (1992), pp. 997
[52.]
A.J. Gissen, L.D. Gugino, S. Datta.
Effects of fentanyl and su-fentanil peripheral mammalian nerves.
Anesth Analg, 62 (1983), pp. 1070-1072
[53.]
S. Datta, D.H. Lambert, J. Gregus.
Differential sensitivities of mammalian nerves during pregnancy.
Anesth Analg, 62 (1983), pp. 1070-1072
[54.]
M.J. Breslow, D.A. Jordan, R. Christopherson.
Epidural morphine decreases postoperative hypertension by attenuating sympathetic nervous system hyperactivity.
JAMA, 261 (1989), pp. 3577-3581
[55.]
H.B. Krebs, R.E. Petres, L.J. Dunn.
Intrapartum fetal heart rate monitoring.
Am J Obstet Gynecol, 138 (1980), pp. 213-219
[56.]
S. Halpern, R. Preston.
Postural puncture headache and spinal needle design.
Metaanalyses. Anaesthesiology, 81 (1994), pp. 1376-1383
Copyright © 2001. Elsevier España, S.L.. Todos los derechos reservados
