Anesthetics complications in preeclamptic patients

Abstract

Introduction: preeclampsia is a hypertensive disorder characterized by hypertension after 20 weeks of gestation, in most cases associated with proteinuria, and may be related to target organ dysfunction. Objective: To perform a literature review regarding complications related to either neuroaxial techniques or general anesthesia in patients with PE. Methods: A literature search was carried out by consulting multiple databases in both Spanish and English, with different combinations of MeSH terms. An analysis and summary of the information reviewed was performed after careful evaluation of the literature. Results: Both neuraxial techniques and general anesthesia in patients with PE could lead to a series of complications which will vary in severity and frequency, with estimates of adverse events of any type of approximately 10% described in the literature. Among the complications that occur with the use of neuraxial techniques are: hypotension, urinary retention and post-puncture headache among others. On the other hand, some of the potential complications with the use of general anesthesia are the development of intracerebral hemorrhage due to increased blood pressure during laryngoscopy, development of pulmonary edema or difficulty with the airway management. The development of hemodynamic instability, drug allergy, nausea and vomiting, cardiac arrest, and mortality are potential complications of both anesthetic techniques. Conclusions: Neuraxial techniques are considered the method of choice even in patients with preeclampsia, as long as there is no contraindication for its use, considering the risk-benefit balance between the potential complications of both anesthetic techniques.