Eficacia terapéutica en hipotensión arterial obstétrica inducida por anestesia subaracnoidea. Revisión sistemática

Abstract

Background: subarachnoid anesthesia is the technique of choice used in pregnant women undergoing cesarean section. Maternal-fetal hypotension is the main adverse effect, with an incidence of up to 70%. Currently, there are controversies regarding its therapeutic management. Objective: to evaluate the therapeutic efficacy in obstetric arterial hypotension after subarachnoid anesthesia. Methods: observational systematic review study. Randomized controlled trials, analytical, cohort, case-control studies and descriptive studies of current scientific articles from the last 5 years and that met the inclusion and exclusion criteria were included. The search strategy consisted of placing keywords and combining with the Boolean operators "AND", "OR" and "NOT" without language restriction. The information was obtained through the search engines: Hinari, Scopus, Redalyc, Scielo, Pubmed, Springer, NJM, BMJ, Cochrane Latindex and academic Google. Results: the left lateral position reduces the frequency of hypotension p <0.05. The administration of colloid solutions is associated with shorter periods of hypotension in relation to crystalloids p <0.05 and is associated with a lower need for vasopressors p <0.05. The use of norepinephrine is associated with fewer episodes of hypotension, as is fetal bradycardia p <0.05. Conclusions: there is a lower incidence of maternal hypotension secondary to spinal anesthesia with measures such as left lateralization of the uterus, administration of colloid solutions, and finally, norepinephrine is considered a vasopressor that provides greater stability in obstetric hypotension.