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Parálisis del nervio motor ocular externo luego de anestesia neuroaxial combinada epidural-espinal / Paralysis of the external oculomotor nerve after combined epidural-spinal neuroaxial anesthesia
López Lazo, Sarah E; Caballero Martínez, Obdulia de la Caridad; Hero Pérez, Elizabeth.
  • López Lazo, Sarah E; Hospital Universitario Ginecobstétrico Provincial "Ana Betancourt de Mora". Camagüey. CU
  • Caballero Martínez, Obdulia de la Caridad; Hospital Universitario Ginecobstétrico Provincial "Ana Betancourt de Mora". Camagüey. CU
  • Hero Pérez, Elizabeth; Hospital Universitario Ginecobstétrico Provincial "Ana Betancourt de Mora". Camagüey. CU
Rev. cuba. anestesiol. reanim ; 19(1): e576, ene.-abr. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093132
RESUMEN

Introducción:

El abordaje del espacio subaracnoideo fue descrito por Quincke en el 1891. En la actualidad es práctica común para la realización de la anestesia neuroaxial subaracnoidea en las pacientes obstétricas. Las complicaciones descritas, asociadas a esto, son varias. Dentro de estas, la parálisis del nervio abducens o VI par no es frecuente y en ocasiones, no está relacionada a la punción ya que se produce días después del evento.

Objetivo:

Revisar la información relacionada con la complicación de parálisis del VI par. Presentación del caso Paciente de 33 años de edad, femenina, de profesión médico, con antecedentes personales de migraña, historia de anestesia neuroaxial epidural sin complicaciones, que para la realización de una cesárea de segmento arciforme y salpinguectomia parcial bilateral, recibió una anestesia combinada peridural-espinal. El transoperatorio transcurre con estabilidad hemodinámica, hizo cefalea al tercer día del posoperatorio, que la atribuyó al antecedente de migraña y fue tratada sin evaluación por anestesiología con dipirona. A los 10 días de operada hace desviación de la mirada y diplopia, se diagnostica parálisis del VI par. Fue tratada por Neurología y se plantean varios diagnósticos diferenciales. Los estudios imagenológicos resultan negativos, se trató con vitaminas y se produjo remisión a las 6 semanas.

Conclusiones:

El diagnóstico de esta complicación es necesario ya que puede pasar inadvertida la relación con la anestesia y, por tanto, ser mal conducido su tratamiento(AU)
ABSTRACT

Introduction:

The approach to the subarachnoid space was described by Quincke in 1891. It is now a common practice to perform subarachnoid neuroaxial anesthesia in obstetric patients. The complications described, associated with this, are several. Within these, the paralysis of the abducens nerve or sixth pair is not frequent and sometimes is not related to the puncture, since it occurs days after the event.

Objective:

To review the information related to the complication of paralysis of the sixth pair. Case presentation A 33-year-old female patient, a physician, with a personal history of migraine, a history of epidural neuroaxial anesthesia without complications, who underwent combined epidural-spinal anesthesia for performing a cranial segment cesarean section and bilateral partial salpingectomy. The transoperative period runs with hemodynamic stability. There was headache three days after surgery, which was attributed to the migraine history and the patient was treated, without evaluation by anesthesiology, with dipyrone. At 10 days after surgery, the eyes are diverted and diplopia is manifested, paralysis of the sixth pair is diagnosed. She was treated by neurology and several differential diagnoses were proposed. Imaging studies are negative. She was treated with vitamins and remission occurred at six weeks.

Conclusions:

The diagnosis of this complication is necessary, since the relationship with anesthesia may go unnoticed and, therefore, its treatment may be poorly conducted(AU)
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Spinal Puncture / Abducens Nerve Diseases / Anesthesia, Spinal Type of study: Etiology study Limits: Adult / Female / Humans / Pregnancy Language: Spanish Journal: Rev. cuba. anestesiol. reanim Journal subject: Anesthesiology Year: 2020 Type: Article Affiliation country: Cuba Institution/Affiliation country: Hospital Universitario Ginecobstétrico Provincial "Ana Betancourt de Mora"/CU

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Full text: Available Index: LILACS (Americas) Main subject: Spinal Puncture / Abducens Nerve Diseases / Anesthesia, Spinal Type of study: Etiology study Limits: Adult / Female / Humans / Pregnancy Language: Spanish Journal: Rev. cuba. anestesiol. reanim Journal subject: Anesthesiology Year: 2020 Type: Article Affiliation country: Cuba Institution/Affiliation country: Hospital Universitario Ginecobstétrico Provincial "Ana Betancourt de Mora"/CU