RESUMO
El abordaje neuroaxial es de elección para el control del dolor en obstetricia, pero no está exento de riesgos. Las neuropatías periféricas posparto pueden producirse por diferentes condiciones médicas, quirúrgicas y anestésicas, por lo que debemos tenerlas presentes para diagnosticarlas y tratarlas precozmente y así evitar que se atribuyan, por defecto, a la técnica anestésica. Presentamos cuatro casos que se diagnosticaron en el periodo periparto, 2 meralgias parestésicas, 1 neuropatía del femoral y 1 lumbociatalgia, de las cuales solo la lumbociatalgia pudo ser atribuida parcialmente a la técnica anestésica. Tras confirmar su diagnóstico se instauró tratamiento conservador que resolvió ad integrum, dentro de los primeros siete días, todas las neuropatías salvo la lumbociatalgia. La baja incidencia de neuropatías periféricas tras técnicas neuroaxiales en obstetricia puede ser superior a la que se diagnostica. Resulta imprescindible una buena anamnesis preanestésica y conocer los diferentes mecanismos fisiopatológicos que pueden desencadenar neuropatías periféricas (AU)
A neuroaxial approach is of choice for the management of pain in obstetrics but is not exempt of risks. Postpartum peripheral neuropathy may occur because of various medical, surgical, and anesthetic conditions, hence we should have them in mind in order to recognize them and treat them early enough to prevent their deffault attribution to the anesthetic technique. We report four cases diagnosed during the peripartum 2 paresthetic meralgias, 1 femoral neuropathy, and 1 lumbosciatalgia, of which only the lumbosciatalgia could be partly attributed to the anesthetic technique. Once the diagnosis was confirmed a conservative therapy was initiated that solved ad integrum all neuropathies, except for the lumbosciatalgia episode, within seven days. The low incidence of peripheral neuropathy following neuroaxial techniques in obstetrics may be higher than diagnosed. Adequate history taking before anesthesia is crucial, as is an understanding of the various pathophysiological mechanisms that may trigger peripheral neuropathy (AU)
