IMPACTO DE LA AMBULACIóN TEMPRANA EN LA REDUCCIóN DE CEFALEA Y DOLOR LUMBAR EN PACIENTES SOMETIDOS A ANESTESIA ESPINAL: REVISIóN SISTEMáTICA Y META-ANáLISIS DE ESTUDIOS EXPERIMENTALES

objective: to determine the impact of early ambulation (ea) versus late ambulation on total headache and back pain after spinal anaesthesia. design: systematic review and meta-analysis, used data sources such as medline, cinahl online, healthstar, embase, the cochrane library controlled trials registry, lilacs and experts. methods: published randomized controlled trials in all languages comparing spinal anesthesia patients allocated to any in-hospital early ambulation or a control/standard treatment (bed rest). four reviewers independently assessed study eligibility and quality; and also performed data extraction. we calculated relative risks (rrs) and 95% confdence intervals (cis) using the random-effects model. outcomes: cefalea or back pain 24 h post-spinal anaesthesia. results: six studies met our eligibility criteria published between 1988-2008. there were 41 cefalea events (16.9% of 242) and 24 back pain events (21.6% of 111) among patients receiving em, compared with 54 cefalea events ( 22.3% of 207) and 32 back pain events (27.5% of 116) among spinal patients receiving control treatment (for cefalea rr=0.67, 95% ci 0.44,1.02; and for lumbar pain rr= 0.79, ic 95% 0.46, 1.34). conclusion: our meta-analysis suggests that there is a possible beneft towards decreased cefalea and back pain with ea after spinal anaesthesia.