Introducción: Los bloqueos del nervio pudendo poseen un amplio rango de ultrasonido del nervio pudendo, neuralgia del pudendo, atra-. Download Citation on ResearchGate | Bloqueo de nervios pudendos guiados por radioscopía.: Presentación de Caso Clínico. | Block of. El bloqueo nervioso anestésico local es una modalidad importante para el tratamiento del dolor en el trabajo de parto. El bloqueo pudendo y el bloqueo.
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Intrapartum blood volume changes. Rev Bras Anestesiol, ; In the conditions of the present study, the sympathetic blockade and the local anesthetic did not have any influence on the coagulation of pregnant women at term undergoing epidural, subarachnoid, or pudendal nerve block.
Nervios anales inferiores – Wikipedia, la enciclopedia libre
Hemoglobin and hematocrit levels were included in this study to rule out the influence of hemodilution on coagulation factors. Alpha angle and maximum amplitude: In patients undergoing general anesthesia, it was observed a tendency to develop a hypercoagulable state, reduction in fibrinolysis, inhibition of platelet aggregation caused by inhalational agents and an increase in the total number of platelets It is known that reduced levels of those factors secondary to hemodilution can affect coagulation J Pharmacol Exp Ther, ; Comparing the different moments, an increase in TT and PT from M 0 to M 2 was observed, followed by a reduction and return to baseline values.
The significant reduction in postoperative thromboembolic complications has been attributed to the use of regional block, probably due to attenuation of the neuroendocrine-metabolic response. Although significant, those results have no clinical implications.
Blood samples were scheduled to be drawn during the period of maximal intensity of the sympathetic blockade and during the peak plasma level of the local anesthetic 23, Anesthesia and surgical intervention also affect coagulation. Table III shows the mean values of the parameters evaluated in all three groups throughout the study. Am J Obstet Gynecol, ; Labor was the fundamental difference between this group and the other two. In the BP group, the evaluation was done before the blockade, after delivery, and 24 hours after the blockade.
Effects of pudendal nerve, epidural and subarachnoid block on coagulation of pregnant women
Normal pregnancy causes changes in coagulation that lead to a hypercoagulable state. Gynecol Obstet Invest, ; Studies comparing general anesthesia to epidural block demonstrated the presence of a postoperative hypercoagulable state in patients undergoing general anesthesia, with a greater incidence of thromboembolic events All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. The study protocol was approved by the Ethics Commission and all patients signed an informed consent.
They also demonstrate that coagulation is activated during labor, which is responsible for the changes seen in all the study groups.
Several authors observed the inhibitory action of local anesthetics on coagulation and the inhibitory action of epidural anesthesia on platelet aggregation In the present study, the spinal block was not responsible for important changes in the coagulation profile. It is known that coagulation is activated after delivery of the fetus, and this is related with uterine contraction during expulsion, reaching maximal activation during the separation of the placenta, which was confirmed by coagulation tests and thromboelastography 29,31, Pregnant women, who demonstrate important hypercoagulability, can in theory benefit from this effect during labor.
We did not find in the literature any reports on the profile of aPTT in pregnant women during or after anesthesia.
Prothrombin and thrombin times behaved similarly in all three groups, increasing after labor M 2. Those changes protect pregnant women from uncontrollable hemorrhage during labor, but at the same time they are responsible for a three- to four-fold increase in the risk of thromboembolism during the puerperium when compared with the remaining of the pregnancy The objective of this study was to determine the effects of regional block on coagulation of pregnant women.
This suggests that coagulation is activated at this moment, probably due to the degeneration of the placental bed that exposes collagen and activates the intrinsic pathway of coagulation Patients were divided in three groups: It is possible that, in the present study, the slight increase detected was an expression of the increased consumption of coagulation factors that begins after expulsion of the placenta, during hemostasis of the surface of the uterus This allowed us to conclude that once labor is initiated, it imposes subclinical changes in coagulation, detected by thromboelastography, lasting at least 24 hours after delivery.
Nervios anales inferiores
Niccolai bW. Top of the page – Article Outline.
It should be noted that blood loss was greater in the BP group, as indicated by the concentration of hemoglobin and hematocrit, which might have influenced the results.
Br J Anaesth, ; This observation is in accordance with that of several pueendo who reported that thromboelastography is pudsndo sensitive and provides faster results in clinical and surgical settings that require repeated measurements to evaluate changes in coagulation dynamics You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Although the three groups behaved differently, only the PD group demonstrated a slight increase in aPTT, which was not clinically significant. New York, Scientific American Medicine, ; Parameters were analyzed in the following moments: Effects of pudendal nerve, epidural pudenfo subarachnoid block on coagulation of pregnant women.
Analysis of the three groups, subjected to different anesthetic techniques, demonstrated a variation in coagulation at different moments only in the BP group.
There were pudendi differences among the three groups regarding: Anaesth Intensive Care. Access to the PDF text. Although we did not find any reports on thromboelastography levels in pregnant women during and after anesthesia, in the present study those changes were observed at the same moments in all three groups, leading to the conclusion that they are secondary to the activation of coagulation caused by labor itself, regardless of the anesthetic technique used.
Pre-anesthetic medication was not administered.