Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural
DOI:
https://doi.org/10.23938/ASSN.0326Palabras clave:
Analgesia obstétrica. Dolor del parto. Epidural. Analgesia controlada por el paciente. Remifentanilo.Resumen
La analgesia epidural es hoy día el método de elección para el tratamiento del dolor del trabajo de parto, el expulsivo y el alumbramiento. Sin embargo, esta técnica puede fallar y aliviar de forma inadecuada (o nula) a la parturienta. En el presente artículo se revisan los factores de riesgo, las posibles causas y las alternativas terapéuticas posibles a la analgesia inadecuada, ya sea mediante terapias farmacológicas (neuroaxiales, bloqueos periféricos o administración de analgésicos vía intravenosa o inhalatoria) o no farmacológicas (técnicas de relajación, psicológicas o mecánicas).
En todos los casos posibles se revisan la eficacia y las indicaciones de las terapias alternativas en función de la literatura publicada, especialmente desde el punto de vista de la medicina basada en la evidencia.
Se insiste en la necesidad de aplicar una aproximación terapéutica multifactorial a la embarazada, no limitándonos solo a eliminar el dolor del parto.
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