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Caracterización de los patrones de pérdida sensorial durante el trabajo de parto analgesia epidural: un estudio
L Kordich1, J P Ghiringhelli1, R B George1
1Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
International journal of obstetric anesthesia
|August 28, 2025
Resumen
La evaluación de la analgesia epidural del parto con sensación de hielo identifica efectivamente la pérdida sensorial completa por debajo de T10 durante el dolor de ruptura. El restablecimiento de la analgesia eleva este nivel a T10 o más, optimizando el manejo del dolor.
Área de la Ciencia:
- Anestesiología y tratamiento del dolor
- Obstetricia y ginecología
Sus antecedentes:
- La analgesia epidural durante el trabajo de parto implica la evaluación de la pérdida sensorial cefálica, con dos niveles distintos: completo y parcial.
- El dolor de ruptura durante el parto puede estar asociado con una insuficiente propagación de la analgesia epidural.
Objetivo del estudio:
- Para determinar los niveles de pérdida sensorial completa y parcial durante el trabajo de parto analgesia epidural cuando los pacientes experimentan dolor de ruptura.
- Evaluar cómo cambian estos niveles de pérdida sensorial después de restablecer la analgesia efectiva.
Principales métodos:
- Se realizó un estudio de cohorte exploratorio prospectivo.
- Los niveles de pérdida sensorial (completa y parcial) al hielo y al pinchazo se evaluaron durante el dolor de ruptura y después del restablecimiento de la analgesia en 30 pacientes en trabajo de parto.
Principales resultados:
- El nivel medio de pérdida sensorial completa al hielo aumentó de T12 durante el dolor a T10 después del restablecimiento de la analgesia.
- El nivel medio de pérdida sensorial completa por pinchazo aumentó de T12 durante el dolor a T11 después del restablecimiento de la analgesia.
- La pérdida sensorial parcial por hielo y pinchazo fue consistentemente superior a T10 tanto antes como después de la recarga de analgesia.
Conclusiones:
- Los pacientes con dolor de parto de avance exhiben pérdida sensorial completa por debajo de T10.
- La evaluación sensorial del hielo, que muestra un aumento a T10 o superior después de la analgesia, puede ser preferida para evaluar la eficacia de la analgesia epidural del parto.
- La optimización de la analgesia epidural del trabajo de parto se puede lograr mediante el monitoreo de la pérdida sensorial completa al hielo.
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