Anestesia general para cesárea. Papel del sugammadex en la calidad y la seguridad del acto anestésico. Reporte de caso

Abstract

C-section is one of the most common surgical procedures in the world, with 5% of the cases being managed under general anesthesia (7.5 million C-sections performed under general anesthesia every year). Due to its special circumstances (i.e., the patient has a full stomach, need for neuromuscular relaxation, mother-child wellbeing, the mother is expected to immediately provide care to the baby, and the procedure takes a short time), general anesthesia is a challenge in every case. This article discusses the case of a pregnant woman who required general anesthesia for an emergency C-section. The neuromuscular relaxant used was Rocuronium. The airway was secured promptly and the surgical conditions were appropriate. The procedure was finally reversed with sugammadex at a dose of 1mg/kg. The availability of new neuromuscular relaxation reversal agents contributes to safe management during anesthesia; furthermore, these agents limit the chances of a residual relaxation and allow better time control and depth of relaxation. Studies suggest sugammadex doses that will probably change with the advent of new trials, adapting them to the degree of neuromuscular relaxation obtained, and this will help to reduce costs and hence improve the availability of the drug in our ORs.