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Es inevitable. Cuando a un paciente le dicen que le van a poner la anestesia epidural, los nervios siempre hacen acto de presencia. Aunque este tipo de anestesia, utilizada normalmente para los partos y operaciones de rodilla o de cadera, elimina el dolor de la intervención –que se lo digan a las madres-, las posibles complicaciones que conlleva siguen siendo un motivo de preocupación. Pero ahora, un nuevo y exhaustivo trabajo británico concluye que estos riesgos se han exagerado y, en realidad, la epidural no es tan mala como la pintan.

Investigadores del Royal United Hospital de Bath, de la Universidad de Dundee y del Wrexham Maelor Hospital (todos en el Reino Unido) han analizado 707.455 intervenciones con epidural realizadas entre 2006 y 2007 y las complicaciones derivadas de las mismas. El trabajo, que publica la revista 'British Journal of Anaesthesia', estima que el riesgo de que se produzca alguna lesión por culpa de la epidural es, en el escenario más pesimista, de uno por cada 23.000 intervenciones, 10 veces menos de lo que se pensaba.

En el caso de las mujeres que utilizan la epidural para dar a luz, el riesgo es aún menor y la probabilidad de que ocurra una lesión permanente (considerando como tal aquella que persiste durante más de seis meses) es, en el peor de los casos, de una entre 80.000.

"En todos los grupos de pacientes que hemos estudiado, los datos son tranquilizadores. Las cifras revelan que la epidural es mucho más segura de lo que creíamos", ha afirmado al diario 'The Times' Tim Cook, anestesista del Hospital de Bath y coordinador del estudio, que se destaca la importancia de esta buena noticia.

De las más de 700.000 intervenciones con epidural analizadas, los investigadores observaron complicaciones en 84 casos. Las más graves –fallecimiento o lesión permanente- se dieron en pacientes mayores, de más de 70 años, y con una salud delicada. "Se trata de personas con varios problemas médicos en las que el sólo hecho de someterse a una intervención quirúrgica ya entraña algún riesgo", explica Cook. Antes de decidir si utilizar o no la anestesia, los autores recomiendan estudiar con detalle la historia clínica y las características del paciente.

Una antigua polémica
Las complicaciones a las que se refieren los autores y que se han asociado tradicionalmente con dicha anestesia van desde un hematoma vertebral, meningitis o un daño en un nervio hasta un colapso cardiovascular que puede llegar a ser mortal.

Algunos casos de paraplejia tras intervenciones con epidural hicieron cundir el pánico hasta el punto de que en EEUU y Reino Unido casi se dejó de utilizar esta anestesia durante varios años tras la Segunda Guerra Mundial. Después, la técnica volvió a emplearse y los estudios para evaluar su seguridad arrojaron datos contradictorios.

Este nuevo análisis, que los autores consideran fiable porque está basado en una población relevante y no sólo en una muestra, viene a tranquilizar a los pacientes al demostrar que los riesgos, aunque los hay, no son tantos como se piensa. "Ahora tenemos datos suficientes para informar con más claridad sobre los posibles peligros de la epidural". elmundosalud
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