<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0484-7903</journal-id>
<journal-title><![CDATA[Revista mexicana de anestesiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. anestesiol.]]></abbrev-journal-title>
<issn>0484-7903</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Anestesiología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0484-79032021000400250</article-id>
<article-id pub-id-type="doi">10.35366/100869</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Autoidentificación de la cintura-útil en la ubicación del sitio de punción en anestesia neuroaxial de paciente obstétrica con obesidad clase III]]></article-title>
<article-title xml:lang="en"><![CDATA[Self-identification of the waist - useful in the location of the puncture site in neuroaxial anesthesia of obstetric patient with class III obesity]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaona-Ramírez]]></surname>
<given-names><![CDATA[Martha Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Estatal de Medicina Ivan Petrovich Pávlov de San Petersburgo IMSS Instituto Nacional de Salud Pública]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Rusia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>44</volume>
<numero>4</numero>
<fpage>250</fpage>
<lpage>257</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0484-79032021000400250&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0484-79032021000400250&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0484-79032021000400250&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La técnica anestésica neuroaxial en la paciente embarazada obesa clase III puede representar un reto para el anestesiólogo, debido a la dificultad para reconocer las referencias anatómicas. El objetivo del estudio fue determinar la dificultad y la calidad de la anestesia combinada espinal/epidural, en 14 pacientes embarazadas con índice de masa corporal &#8805; 40 kg/m2, programadas para cesárea. Para la localización del sitio de punción, se utilizó la autoidentificación de cintura, metodología no reportada previamente. Las pacientes se sentaron a horcajadas en la mesa quirúrgica, señalaron el lugar de su cintura con sus manos. Se trazaron dos rectas en la espalda, una recta horizontal en la cintura señalada por la paciente, y una recta vertical correspondiente a la línea media. La intersección de las dos rectas fue la coordenada para la punción neuroaxial. La media ± DE del índice de masa corporal fue 47.5 ± 3.7 kg/m2. Se determinó una tasa de éxito del primer nivel del 92.8%, un promedio de punciones de 1.5 y 57.1% de las pacientes recibió una punción. La anestesia espinal/epidural falló en dos casos, se realizó cambio de técnica anestésica a epidural, y complementación con infiltración local, con adecuada analgesia. No fue necesario convertir a anestesia general en ningún caso. La autoidentificación de la cintura puede ser una ayuda clínica para la identificación del sitio de la punción lumbar durante la instalación de la anestesia neuroaxial, en pacientes obstétricas con obesidad clase III programadas para cesárea.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: The neuraxial anesthetic technique in the obese class III, pregnant patient, can represent a challenge for the anesthesiologist, due to the difficulty in recognizing the anatomical landmarks. The objective of the study was to determine the difficulty and quality of combined spinal/epidural anesthesia, in 14 pregnant patients with a body mass index &#8805; 40 kg/m2 scheduled for cesarean section. For the location of the puncture site, self-identification of the waist was used, a methodology that has not been previously reported. The patients straddled the surgical Table, pointing to her waist with both hands. Two lines were drawn on the back. A horizontal line at the waist, indicated by the patient, and a vertical line corresponding to the midline. The intersection of the two lines was the coordinate for the neuraxial puncture. The mean ± SD of the body mass index was 47.5 ± 3.7 kg/m2. A first level success rate of 92.8% was determined, 57.1% of the patients received one puncture, and the average of punctures was 1.5. Spinal/epidural anesthesia failed in two cases, a change from anesthetic technique to epidural and supplementation with infiltration was performed, with adequate analgesia. It was not necessary to convert to general anesthesia in any case. Self-identification of the waist and coordinate marking can be a clinical aid for the identification of the lumbar puncture site, during the installation of neuraxial anesthesia, in obstetric patients with class III obesity, scheduled for cesarean section.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cintura]]></kwd>
<kwd lng="es"><![CDATA[coordenada]]></kwd>
<kwd lng="es"><![CDATA[punción]]></kwd>
<kwd lng="es"><![CDATA[anestesia]]></kwd>
<kwd lng="es"><![CDATA[neuroaxial]]></kwd>
<kwd lng="es"><![CDATA[obesidad]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="en"><![CDATA[Waist]]></kwd>
<kwd lng="en"><![CDATA[coordinate]]></kwd>
<kwd lng="en"><![CDATA[puncture]]></kwd>
<kwd lng="en"><![CDATA[anesthesia]]></kwd>
<kwd lng="en"><![CDATA[neuraxial]]></kwd>
<kwd lng="en"><![CDATA[obesity]]></kwd>
<kwd lng="en"><![CDATA[cesarean section]]></kwd>
</kwd-group>
</article-meta>
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