Recomendaciones para la buena práctica de la medicina en anestesiología

espanolEn la actualidad, la Anestesiologia se reconoce como una disciplina medica y las actividades del anestesiologo son amplias, ya que se involucra en todos los procesos que ocurren durante el acto anestesico-quirurgico. La causa mas comun de danos o complicaciones serias estan asociadas con fallas en la ventilacion adecuada del paciente. El objetivo del presente trabajo es emitir recomendaciones generales y especificas, dirigidas a los especialistas de Anestesiologia, a partir del analisis de las quejas recibidas en la CONAMED. Se analizaron todas las quejas recibidas en la CONAMED para la especialidad de anestesiologia de junio de 1996 a mayo de 2001. Se incluyeron variables sociodemograficas, de la institucion de salud y motivo de queja entre otras. Se incluyo informacion de la Valoracion Medica Integral, para obtener el tipo de anestesia utilizada. Para el analisis se empleo estadistica descriptiva, para este proposito se utilizo el paquete estadistico SPSS 10.1. Resultados: se analizaron un total de 97 quejas, 74.2% de las quejas correspondieron al sexo femenino, promedio de edad pacientes 34.3 anos, la mayor proporcion de las quejas correspondio a instituciones de Seguridad Social (67.0%). La proporcion de mala practica por tipo de institucion fue de 75% en las privadas, 57.4% en seguridad social y 52.6% en servicios publicos. Los problemas identificados con mayor frecuencia en las quejas con mala practica fueron: perforacion de duramadre, seguida por la encefalopatia anoxoisquemica, el tercer lugar para dano cerebral irreversible y lesion de raices nerviosas. Se identificaron 5 defunciones relacionadas con la anestesia. Los resultados obtenidos en el presente trabajo en cuanto a los problemas en la practica de la anestesiologia son muy semejantes a los reportados en la literatura y una proporcion de casos pueden ser prevenibles a traves de una mejor capacitacion y supervision de los procedimientos anestesicos que se realizan. EnglishAt present, the Anesthesiology is recognized as a medical discipline and the activities of the anesthesiologist are wide, since it interferes in all the processes that happen during the anesthetic - surgical act. The most common reason of damages or serious complications they are associated with faults in the suitable ventilation of the patient. The aim of the present work is to generate specific and general recommendations directed to specialists of Anesthesiology, from the analysis of the complaints received in the CONAMED. There were analyzed all the complaints received for the specialty of anesthesiology from June, 1996 to May, 2001. Sociodemographic variables were included, information about institution of health and motive of complaint among others. There was included information of the Medical Integral Valuation, to obtain the type of used anesthesia. For the analysis descriptive statistics was used, for this intention it was used SPSS 10.1. Results: there was analyzed a whole of 97 complaints, 74.2 % of the complaints corresponded to the female sex, average of age 34.3 years, the major proportion of the complaints were to institutions of Social Security (67.0%). The proportion of malpractice for type of institution was of 75 % in the private roads, 57.4 % in Social Security and 52.6% in the Public Services. Problems identified with major frequency in the complaints with malpractice were in order: dural puncture, encephalopathy ischemic and cerebral irreversible damage and injury of nervous roots. Five deaths related with anesthesia were identified. The results obtained in the present work as for the problems in the practice of anesthesiology are very similar to the reported ones in the literature and a proportion of cases they can be prevenibles across a better training and supervision of the procedures that are realized.