Cuidados enfermeros en las principales complicaciones de la analgesia epidural en el parto. Revisión narrativa
Fecha
2016-07-21
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Jaén: Universidad de Jaén
Resumen
[ES] La analgesia epidural es una técnica invasiva que permite la instauración de un catéter para control del dolor durante el proceso del parto. Es una técnica muy efectiva y segura, sin embargo, entraña una serie de complicaciones una vez colocado el catéter. Las más importantes son: cefalea, retención urinaria e hipotensión. Enfermería debe de saber anticiparse a estas complicaciones y saber la actuación en cada caso. Objetivos: conocer los cuidados de enfermería más eficaces para la analgesia epidural y sus complicaciones en el proceso del parto. Metodología: se ha realizado una revisión narrativa de la bibliografía existente en las bases de datos de Cochrane Plus, Scopus, Cuiden Plus, Lilacs, Google Academico, Cinalh y Pubmed. Los criterios de inclusión han sido todo tipo de documentos posteriores al 2006 aunque en algunas bases de datos he tenido que ampliar el rango, también he utilizado artículos tanto en español como en inglés. Resultados: se han obtenido y analizado un total de 9 artículos relacionados directamente con el tema que nos aborda. Conclusiones: la evidencia nos orienta hacia la deambulación temprana en el caso de la cefalea. Cuando el paciente padece de retención urinaria, enfermería vigilará la entrada y salida de líquidos valorando también la vejiga, palpándola. Por último, cuando se sufre hipotensión grave lo correcto y más efectivo sería la canalización de una vía venosa periférica para la reposición de los líquidos. No obstante, la investigación de enfermería acerca de todas las complicaciones en la analgesia epidural debería de continuar ya que existe poca evidencia científica no sólo en estas tres complicaciones si no, en todas las demás.
[EN] The epidural analgesia is an invasive procedure which allows the establishment of a catheter in order to control the pain during the labour. It is a very effective and reliable technique, however, it entails too many complications once the catheter is placed. The most important risks are: headache, urinary retention and low blood pressure. Nursing department should know how to be ahead of themselves when those complications appear and how to act in each single situation. Aims: know the most efficient nursing care areas for the epidural analgesia as well as its complications during the labour. Methodology: an in-depth narrative overview has been undertaken, bearing in mind all the existing bibliography that we may find in the Cochrane Plus, Scopus, Cuiden Plus, Lilacs, Google Academic, Cinalh and Pubmed database. Even though all kind of documents later on 2006 have been used as the criterion for inclusion, in many databases. I had to extend the range. It should be note that I have used either English or Spanish documents. Results: a total of 9 articles directly related with the subject matter have been found and analyzed. Conclusions: in the case of headache the evidence points us toward the early wandering. However, if the patient suffers urinary retention, nursing would keep an eye on the liquids inlets and oulets and would care for the bladder, palpating it. Finally, when low blood pressure is suffered, the right and most effective thing would be the channeling intravenous access in order to replace fluids that have been lost. Nevertheless, the study on all the complications related with the epidural analgesia should continue, owing to the lack of scientific proof not only in these three complications, but in every single one.
[EN] The epidural analgesia is an invasive procedure which allows the establishment of a catheter in order to control the pain during the labour. It is a very effective and reliable technique, however, it entails too many complications once the catheter is placed. The most important risks are: headache, urinary retention and low blood pressure. Nursing department should know how to be ahead of themselves when those complications appear and how to act in each single situation. Aims: know the most efficient nursing care areas for the epidural analgesia as well as its complications during the labour. Methodology: an in-depth narrative overview has been undertaken, bearing in mind all the existing bibliography that we may find in the Cochrane Plus, Scopus, Cuiden Plus, Lilacs, Google Academic, Cinalh and Pubmed database. Even though all kind of documents later on 2006 have been used as the criterion for inclusion, in many databases. I had to extend the range. It should be note that I have used either English or Spanish documents. Results: a total of 9 articles directly related with the subject matter have been found and analyzed. Conclusions: in the case of headache the evidence points us toward the early wandering. However, if the patient suffers urinary retention, nursing would keep an eye on the liquids inlets and oulets and would care for the bladder, palpating it. Finally, when low blood pressure is suffered, the right and most effective thing would be the channeling intravenous access in order to replace fluids that have been lost. Nevertheless, the study on all the complications related with the epidural analgesia should continue, owing to the lack of scientific proof not only in these three complications, but in every single one.