Técnicas intravenosas para operación cesárea

The present prospective case series evaluated six pregnant patient with diagnostic of severe preeclampsia complicated with HELLP syndrome undergoing urgent caesarean delivery in the Maternal Child Unit of Clinica Universitaria Bolivariana using an intravenous technique with propofol and remifentanil. A 1 mcg/kg bolus of remifentanil was given intravenously, followed by a continuous infusion of 0.1 to 0.5 mcg/kg/min and 2 mg/kg bolus of propofol followed by a continuous infusion of 100 200 mcg/kg/min. None of the patients presented hypotension or bradycardia during anesthetic induction or maintenance. Just one patient developed uterine atony but this patient had a time uterine incision delivery of more than three minutes. No awareness nor maternal mortality were found. Two neonatal deaths in babies with weight less than 1200 grams for extreme prematurity and hyaline membrane disease were reported. One minute APGAR was 5 in average and five minutes APGAR was 8 in average. Just one neonate required mechanical ventilation for hyaline membrane disease and just one neonate required naloxone, according to neonatologist criteria. The present case series is the first in our ground that describes total intravenous anesthesia based on propofol and remifentanil in pregnant patients with diagnostic of HELLP and it is suggested as an alternative to traditional techniques of general anesthesia in pregnant patients with this kind of disease.