[Epidural vs. intradural anesthesia in ambulatory surgery].
Spinal anesthesia is the technique of choice for many outpatient procedures. With appropriate screening and preparation, it can provide excellent surgical conditions and highly satisfactory anesthesia for the patient, while remaining cost-effective. Intradural anesthesia has advantages over epidural anesthesia: technical simplicity, rapid onset, efficacy and depth of blockade. Its use has been controversial, however, for many years due to the potential risk of headache after puncture of the dura mater. Epidural anesthesia causes fewer hemodynamic changes and provides greater dose flexibility and local anesthetic concentration, with less risk of headache after accidental puncture of the dura mater. The drawbacks are that it takes longer to perform and onset of blockade comes later. Both techniques are valid alternatives to general anesthesia in outpatient surgery. The choice of one over the other will depend on patient characteristics, availability of a presurgical area, and the anesthesiologist's skill.
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Servicio de Anestesiología y Reanimación, Hospital de Viladecans, Barcelona.
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D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000191:economics; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000191:economics; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D001416:Back Pain / Q000209:etiology; D001919:Bradycardia / Q000209:etiology; D004388:Dura Mater / Q000293:injuries; D005283:Fentanyl / Q000008:administration & dosage; D006261:Headache / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008012:Lidocaine; D005283:Fentanyl
Anestesia epidural frente a anestesia intradural en cirugía ambulatoria.