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Dosis efectiva del 90% de ropivacaína espinal para versión cefálica externa: un estudio secuencial de determinación
Qiao Shi1,2, Jing Zheng1,2, Tao Xu1,2
1Department of Anesthesiology, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, China.
The Journal of international medical research
|February 20, 2026
Resumen
La dosis intratecal óptima de ropivacaína para la versión cefálica externa (VCE) con anestesia espinal es de 3.0 mg, combinada con fentanilo. Esta dosis equilibra el alivio eficaz del dolor y la seguridad durante el procedimiento.
Área de la Ciencia:
- Anestesiología; Obstetricia; Manejo del dolor
Sus antecedentes:
- La anestesia espinal mejora el éxito de la versión cefálica externa (VCE).
- La dosis óptima de ropivacaína para la anestesia espinal de la VCE no está bien definida.
- Dosis más altas de ropivacaína pueden presentar mayores riesgos.
Objetivo del estudio:
- Determinar la dosis efectiva del 90% (DE90) de ropivacaína intratecal para la VCE.
- Establecer el perfil analgésico y de seguridad óptimo de la ropivacaína en la VCE.
Principales métodos:
- Estudio secuencial de determinación de dosis, prospectivo y doble ciego.
- Cuarenta parturientas recibieron anestesia espinal con ropivacaína y fentanilo.
- Ajustes de dosis basados en la eficacia analgésica (EVA ≤30 mm) utilizando un diseño de moneda sesgada arriba y abajo.
Principales resultados:
- La DE90 estimada de ropivacaína intratecal con fentanilo fue de 3,22 mg.
- Las puntuaciones medianas de la EVA fueron significativamente más bajas en el grupo de 3,5 mg (p < 0,05).
- Las hemodinámicas maternas y fetales se mantuvieron estables en todos los grupos de dosis.
Conclusiones:
- Una dosis de 3,0 mg de ropivacaína con 10 µg de fentanilo ofrece un buen equilibrio entre eficacia y seguridad.
- Se recomienda esta dosificación para uso clínico en anestesia espinal para VCE.
- Investigaciones futuras pueden explorar estrategias de dosificación refinadas para el manejo del dolor en VCE.
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