CEFALEA POSPUNCIÓN DURAL EN ANESTESIA RAQUÍDEA: REVISIÓN BIBLIOGRÁFICA SOBRE INCIDENCIA, FACTORES DE RIESGO Y ESTRATEGIAS DE TRATAMIENTO
DOI:
https://doi.org/10.47820/recima21.v5i6.5321Palabras clave:
Cefalea postpunción dural. Anestesia raquídea. Incidencia, factores de riesgo. Estrategias de gestión.Resumen
La cefalea pospunción dural (CPPD) es una complicación frecuente y debilitante tras la anestesia raquídea, que repercute negativamente en la recuperación del paciente y aumenta los costes sanitarios. Objetivo: Esta revisión bibliográfica pretende abordar la incidencia, los factores de riesgo y las estrategias de tratamiento de la CPPD en pacientes sometidos a anestesia raquídea. Métodos: Esta revisión bibliográfica se realizó mediante una búsqueda sistemática de la literatura científica publicada en los últimos 15 años, abarcando el periodo comprendido entre 2009 y 2024, en las bases de datos PubMed, Web of Science, Scopus y Google Scholar. Los criterios de inclusión fueron estudios originales y revisiones, en inglés, portugués o español, que investigaran estrategias de intervención para la PDPH. Se excluyeron informes de casos, editoriales y estudios centrados en otras condiciones médicas. Resultados y Discusión: La incidencia de la HPPD oscila entre el 0,1% y el 36% y está influida por la técnica anestésica y las características del paciente. Los factores de riesgo son la edad, el sexo femenino y el embarazo. La elección de agujas de menor calibre con punta de lápiz reduce la incidencia de HPPD. Las técnicas de punción guiadas por ecografía minimizan las punciones traumáticas. El tratamiento conservador, que incluye la hidratación y el uso de analgésicos, es eficaz en los casos leves. El parche sanguíneo epidural es el tratamiento de referencia para los casos graves, mientras que los derivados de la cafeína son una alternativa prometedora.
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