The Relationship between the Phases of the Menstrual Cycle on the Incidence and Severity of Headache after Spinal Anesthesia

Abstract Introduction Headache after spinal anesthesia is a common complication, which is caused after dural puncture due to discharge of cerebrospinal fluid and reduction in the volume and pressure. Studies have shown that a variety of factors are involved including needle shape, needle size, patient's sex, age, duration of surgery, history of spinal anesthesia, and history of headaches. One possible factor is the phase of the menstrual cycle. Many studies have investigated the effect of the menstrual cycle on factors such as postoperative nausea, vomiting, propofol injection pain, and sore throat after intubation. Also, many studies have investigated the effect of different phases of the menstrual cycle on migraine headaches. Therefore, we decided to investigate the effect of different phases of the menstrual cycle on headache after spinal anesthesia. Materials and Methods To determine the relationship between headache after spinal anesthesia and menstrual cycle, the study included all the patients undergoing spinal anesthesia in Shohada Ashayer and Asalian Hospitals of Khorramabad. This cohort study included 279 patients, and data collection tool was a questionnaire. The data from the questionnaire included age, menstrual phase, surgical procedures, pain location, pain intensity, history of spinal anesthesia, history of headache, and headache after spinal anesthesia. Results There was no statistically significant difference between the location of headache, the history of spinal anesthesia, the location of headache, the history of headache, and menstrual phase. Conclusion Considering the high incidence of postdural puncture headache in follicular phase, it is recommended that patients with a high risk of headaches undergo spinal anesthesia and surgery in the luteal phase.

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A preliminary study exploring the change in ankle joint laxity and general joint laxity during the menstrual cycle in cis women

Journal of Foot and Ankle Research ◽

10.1186/s13047-021-00459-7 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Tomomi Yamazaki ◽

Sae Maruyama ◽

Yuki Sato ◽

Yukako Suzuki ◽

Sohei Shimizu ◽

...

Keyword(s):

Menstrual Cycle ◽

Ankle Joint ◽

Length Change ◽

Joint Laxity ◽

Anterior Talofibular Ligament ◽

Menstrual Phase ◽

Anterior Drawer ◽

Linear Distance ◽

Significant Difference ◽

Early Follicular Phase

Abstract Background The purpose of the present study was to examine the relationship between ankle joint laxity and general joint laxity (GJL) in relation to the menstrual cycle, which was divided into four phases based on basal body temperature and ovulation, assessed using an ovulation kit. Methods Participants were 14 female college students (21–22 years) with normal menstrual cycles (cis gender). Anterior drawer stress to a magnitude of 120 N was applied for all participants. Anterior talofibular ligament (ATFL) length was measured as the linear distance (mm) between its points of attachment on the lateral malleolus and talus using ultrasonography. Data on ATFL length from each subject were used to calculate each subject’s normalized length change with anterior drawer stress (AD%). The University of Tokyo method was used for evaluation of GJL. AD% and GJL were measured once in each menstrual phase. Results There was no statistically significant difference between AD% in each phase. GJL score was significantly higher in the ovulation and luteal phases compared with the early follicular phase. AD% and GJL showed a positive correlation with each other in the ovulation phase. Conclusions Although it is unclear whether estrogen receptors are present in the ATFL, the present study suggests that women with high GJL scores might be more sensitive to the effects of estrogen, resulting in ATFL length change in the ovulation phase.

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Comparison of patient and surgeon satisfaction in patients undergoing knee arthroscopy with peripheral nerve block versus spinal anesthesia

Journal of Clinical and Investigative Surgery ◽

10.25083/2559.5555/6.2.10 ◽

2021 ◽

Vol 6 (2) ◽

pp. 148-152

Author(s):

Seray Turkmen ◽

◽

Mehmet Mutlu

Keyword(s):

Peripheral Nerve ◽

Spinal Anesthesia ◽

Nerve Block ◽

Knee Arthroscopy ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Rescue Analgesia ◽

Significant Difference ◽

Duration Of Surgery ◽

Surgeon Satisfaction

Objective. This study aims to compare two different methods of regional anesthesia applied for knee arthroscopy in terms of patient and surgeon satisfaction. Materials and Methods. Eighty patients who underwent knee arthroscopy either with spinal anesthesia (SA) or unilateral sciatic and femoral nerve block (SFNB) were included in the study. A nurse conducted a blind study questionnaire to assess the surgeon and patient satisfaction from anesthesia performed at the end of the surgery. Pain score, demographical data, duration of surgery, motor and sensory block duration, time of first rescue analgesia were recorded and analyzed statistically. Results. A statistically significant difference was found between the patient (p = 0.001; p <0.01) and surgeon (p = 0.022; p <0.05) satisfaction rates, these being lower in the group with SFNB comparable to patients with spinal anesthesia. There was a statistically significant difference between the first analgesic requirements of the patients according to the groups (p = 0.001; p <0.01). The first analgesic requirement of the patients who received SFNB was later than in the case of patients who received spinal anesthesia. Conclusions. Patient and surgeon satisfaction with SA was significantly higher than SFNB. The peripheral nerve blocks are inadequate for patient and surgeon satisfaction for knee arthroscopy compared to SA.

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Negative Mood Is Associated with Diet and Dietary Antioxidants in University Students During the Menstrual Cycle: A Cross-Sectional Study from Guangzhou, China

Antioxidants ◽

10.3390/antiox9010023 ◽

2019 ◽

Vol 9 (1) ◽

pp. 23

Author(s):

Lingling Bu ◽

Yuting Lai ◽

Yingyan Deng ◽

Chenlu Xiong ◽

Fengying Li ◽

...

Keyword(s):

Logistic Regression ◽

Menstrual Cycle ◽

Negative Affect ◽

University Students ◽

Premenstrual Syndrome ◽

Odds Ratio ◽

Negative Mood ◽

Menstrual Phase ◽

Carbonated Beverage ◽

The Relationship

Postpubescent females may have negative mood or premenstrual syndrome during the menstrual cycle; with the emotional and physical symptoms interfering with their quality of life. Little is known about the relationship of dietary behaviors and dietary antioxidant intake with negative mood or premenstrual syndrome in university students in China; so we explored the relationship between negative mood and dietary behavior in female university students during the three menstrual cycle phases. Random sampling was used to enroll 88 individuals from a university in Guangzhou; China in the study. Data were collected using self-administered questionnaires. Descriptive statistics and multiple logistic regression analyses were performed. During the menstrual phase, tea, black coffee and carbonated beverage intake was higher in the group with a high negative affect scale score than in the low score group (p < 0.05). Likewise; during the premenstrual phase, fresh fruit (banana and red Chinese dates) intake was higher in the group with a high negative affect scale score than in the low-score group (p < 0.05). The logistic regression analysis results showed that negative mood was positively associated with tea, coffee, and carbonated beverage intake during the menstrual phase (β = 0.21, p = 0.0453, odds ratio = 1.23), and negative mood was positively associated with banana and red Chinese dates intake during the premenstrual phase (β = 0.59, p = 0.0172, odds ratio = 1.81). Our results suggest that negative mood may be associated with diet and specific food in university postpubescent females.

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Assessment of Cytochrome P450 3A4 Activity during the Menstrual Cycle Using Alfentanil as a Noninvasive Probe

Anesthesiology ◽

10.1097/00000542-199707000-00005 ◽

1997 ◽

Vol 87 (1) ◽

pp. 26-35 ◽

Cited By ~ 45

Author(s):

Evan D. Kharasch ◽

Michael Russell ◽

Kyle Garton ◽

Gretchen Lentz ◽

T. Andrew Bowdle ◽

...

Keyword(s):

Cytochrome P450 ◽

Menstrual Cycle ◽

Compartment Model ◽

Gas Chromatography Mass Spectrometry ◽

Menstrual Phase ◽

Cytochrome P450 Activity ◽

Significant Difference ◽

Clinical Consequences ◽

Stage Analysis ◽

P450 Activity

Background Gender-dependent differences in cytochrome P450 activity, drug metabolism, drug elimination, and their clinical consequences are increasingly apparent. P450 3A4 is the most abundant P450 isoform in the human liver and is responsible for metabolizing a vast and diverse assortment of therapeutic agents, including opioids, benzodiazepines, and local anesthetics. P450, 3A4 activity is higher in women, influenced by steroid hormone levels, and is speculated to vary during the menstrual cycle. This investigation tested the hypothesis that P450 3A4 activity varies during the menstrual cycle. Alfentanil clearance was used as a metabolic probe for P450 3A4 activity. Methods Alfentanil (20 micrograms/kg bolus) was administered to nine nonsmoking, nonpregnant female volunteers (age, 26 +/- 5 yr) with normal menstrual cycles on three separate occasions during the same menstrual cycle: days 2 (menstrual phase), 13 (estrogen peak), and 21 (progesterone peak). Venous plasma alfentanil concentrations were determined by gas chromatography-mass spectrometry. Alfentanil clearance was determined by noncompartmental methods and by a three-compartment model with both pooled population and two-stage analysis. Results There was no significant difference in any measure of alfentanil clearance. Noncompartmental clearances (mean +/- SD) were 3.62 +/- 0.76, 3.81 +/- 0.96, and 3.60 +/- 0.84 ml/kg/ min, respectively, on days 2, 13, and 21 of the menstrual cycle. Conclusions Alfentanil clearances were not different on menstrual cycle days 2, 13, and 21, strongly suggesting no change in P450 3A4 activity. Menstrual cycle differences in alfentanil clearances do not contribute to interindividual variability in alfentanil disposition in women. If other P450 3A4 substrates are comparable, then menstrual cycle variability in their metabolism may not be a consideration in dosing or in the design of pharmacokinetic investigations.

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Sonoelastographic assessment of the normal uterus and ovaries using the Shear Wave Elastography according to different menstrual phases

Aegean Journal of Obstetrics and Gynecology ◽

10.46328/aejog.v3i2.90 ◽

2021 ◽

Vol 3 (2) ◽

pp. 29-32

Author(s):

Özgür Turan ◽

Ersen Ertekin ◽

Oghuz Abdullayev ◽

Behram Kuh

Keyword(s):

Menstrual Cycle ◽

Shear Wave ◽

Systemic Disease ◽

Shear Wave Elastography ◽

Cycle Period ◽

Menstrual Phase ◽

Menstrual Cycles ◽

Pelvic Ultrasonography ◽

Significant Difference ◽

Relationship Of

Objective: In most of the gynecological studies conducted using the Shear Wave Elastography (SWE) method in the literature, the menstrual cycle period was not taken into account. Current study, we aimed to describe the sonoelastographic features of normal myometrium and ovaries in healthy women and to define their variability during the different phases of the menstrual cycle using the SWE method. Material and methods: All cases were selected from individuals between the ages of 24-31, with regular menstrual cycles and no systemic disease. Each case was called in, 1-5th, 12-16th, 21-24th day of their menstrual cycles and was evaluated by B-mode imaging and SWE in pelvic ultrasonography. The relationship of menstrual phases with uterine and ovarian elasticity was investigated by comparing all measurements made in different menstrual phases. Results: No statistically significant difference was observed between the volume of right and left ovaries in terms (p> 0.05). There was no statistically significant difference in terms of elastography measurements obtained from the uterus, right and left ovaries for each menstrual phase according to Bonferroni Correction (p> 0.0163). Conclusion: Although there was a slight decrease in myometrial SWE measurements in the follicular phase, there was no significant difference regarding the SWE measurements of uterus and ovaries in early follicular, peri-ovulatory, and luteal menstrual stages. Further studies with a large number of participants are needed to suggest whether gynecological studies planned to be carried out with the shear wave elastography method should be planned in a specific menstrual phase.

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The Relationship Between Menstruation Cycle and Exercise Participation in Korean Female College Students

10.21203/rs.3.rs-107764/v1 ◽

2020 ◽

Author(s):

Sunghwun Kang ◽

Il Bong Park ◽

Woo Suk Chung

Keyword(s):

Menstrual Cycle ◽

University Students ◽

Menstrual Cycles ◽

Exercise Participation ◽

Regular Menstrual Cycle ◽

Health Consciousness ◽

Significant Difference ◽

Intensity Of Exercise ◽

Intention To Exercise ◽

The Relationship

Abstract Background: The purpose of this study was to examine how Korea female university students participate in physiological and psychological exercises according to differences in their menstrual cycles and health consciousness, exercise participation, and exercise intention. This study analyzed how these female students feel about their own health, participating in exercises, and the duration of the exercise according to the different menstrual cycles and their various patterns. Methods: The study surveyed women university students in Gangwon-do, Busan, and Ulsan metro city in Korea. A total of 464 questionnaires were analyzed using the statistical programs SPSS Win 22 and AMOS Win 22. We used cross-analysis, T-tests, one-way ANOVA analysis, and correlation analysis to analyze differences in health consciousness, intensity of exercise, and degree of intent to exercise in terms of the menstrual cycle and exercise pattern during the cycle. Results: First, there were no significant differences between menstrual pattern (regular vs. irregular) and general exercise periods during the non-menstrual period (X2 = 5.828, p < 0.212). However, the study showed that more female university students who had regular menstrual cycle were back to regular exercise right after their menstruation cycle ended, and the girls with irregular menstrual cycles did not exercise as much right after their menstruation cycle ended. Second, there were significant differences in the relationship between health consciousness (p = 0.000), amount of exercise (p = 0.002), and grade of intention to exercise (p = 0.002) according to the differences in menstrual cycles and pattern of Korean female university students. Female university students with a regular menstrual cycle showed higher health consciousness, amount of exercise, and intent to exercise than did ones with irregular menstrual cycles. Third, there was a significant difference in the relationship between health consciousness (p = 0.000), amount of exercise (p = 0.000), and intent to exercise (p = 0.000) in accordance with exercise period (did not exercise, before menstruation, after menstruation, and when not menstruating, always) of Korean female university students. In other words, female university students who exercised were higher than female university students who did not exercise.Conclusions: In this study, Korean female university students who had regular menstrual cycles exercised regularly and showed a high level of their own health consciousness, amount of exercise, and intention to exercise. Also, female university students who exercise regularly have a higher level of health consciousness, amount of exercise, and intention to exercise. This study will be valuable as a pilot study related to physiological, psychological factors, and exercise of women.

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An Evaluation of Three Different Cranial Cruciate Ligament Surgical Stabilization Procedures As They Relate to Postoperative Meniscal Injuries

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632440 ◽

1995 ◽

Vol 08 (02) ◽

pp. 118-123 ◽

Cited By ~ 44

Author(s):

P. D. Schwarz ◽

M. Salman ◽

M. R. Alvis ◽

A. Metelman

Keyword(s):

At Risk ◽

Cruciate Ligament ◽

Fibular Head ◽

Cranial Cruciate Ligament ◽

Additional Information ◽

Weight History ◽

Significant Difference ◽

History Of ◽

The Relationship ◽

Cranial Cruciate Ligament Rupture

SummaryCranial cruciate ligament (CrCL) rupture is the most commonly diagnosed stifle condition in the dog. Meniscal injury, in conjunction with CrCL rupture is also common in both man and dogs. There is a growing concern regarding meniscal injuries, whether unrecognized at the time of CrCL surgical stabilization or subsequent to stabilization, and the relationship to poor postoperative functional outcome. However, current literature is not specific as to an actual number of dogs subsequently requiring a second arthrotomy/meniscectomy.Three different CrCL stabilization operations in dogs were compared, retrospectively, for the occurrence of post-operative meniscal damage requiring a second arthrotomy and meniscectomy. Additional information concerning: signalment, weight, history of injury, CrCL ruptured, surgeon, type of CrCL rupture and amount of arthritis present was recorded in 665 cases. It was found that 13.8% of the stifles at risk (i. e. those stifles that did not have the meniscus removed at the time of initial surgical stabilization) returned for a second arthrotomy/meniscectomy. A significant difference in outcome was not found between the results when initially performed by different surgeons. The number of dogs which returned for a second arthrotomy/ meniscectomy whose weight were ≤ 15 kg was significant, when compared to the total number of dogs considered at risk for this weight range. There was a significantly lower rate of return, in those dogs at risk, which had received fibular head transposition stabilization.A retrospective study of 665 canine cranial cruciate ligament rupture cases documents the incidence (13.8%) of those dogs requiring a second arthrotomy, and subsequent meniscectomy, after one of three initial surgical stabilization procedures. Of the three procedures, the fibular head transposition technique had a significantly lower return rate requiring subsequent meniscectomy.

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Management of violent behaviour in acutely relapsed schizophrenics

Curationis ◽

10.4102/curationis.v27i4.1025 ◽

2004 ◽

Vol 27 (4) ◽

Author(s):

L. Koen ◽

B.H. Lategan ◽

E. Jordaan ◽

D.J.H. Niehaus ◽

R.A. Emsley

Keyword(s):

Aggressive Behaviour ◽

Assessment Tool ◽

Statistical Correlation ◽

Violent Behaviour ◽

Pharmacological Management ◽

Study Objective ◽

Behaviour Management ◽

Significant Difference ◽

History Of ◽

The Relationship

The management of aggressive behaviour has always been a criticai issue in psychiatry. Finding measures that can be used to accurately predict the likelihood of assaultative behaviour and thus ensure timeous appropriate pharmacological management remains a dilemma. The study objective was to investigate the naturalistic, pharmacological management of inpatient aggressive behaviour in a group of 50 schizophrenic subjects with a view to determine: (1) whether a presenting history of recent violence lead to altered pharmacological management and (2) whether the NOSIE could be regarded as a useful assessment tool with regards to inpatient behaviour management. No significant difference could be demonstrated between the 2 subsets of subjects (history of violence vs none) with respect to total doses of medication administered. No statistical correlation could be found between the total NOSIE score and the dose of psychotropic medication used. The relationship between a subset of NOSIE-items and the total dose of medication was more complex and a clear linear relationship could be demonstrated for a total score of 0 to 5. In this particular ward setting a presenting history of recent violent behaviour did not influence the administration of medication and neither could the clinical judgement employed by the nursing staff to manage inpatient behaviour be captured by the NOSIE. However, a five-item subset of the NOSIE with questions relating to aggression and irritability warrants further scrutiny in this regard.

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Nosographic considerations on obsessive-compulsive disorder occurring exclusively during the menstrual phase

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1190 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Hicham Laaraj ◽

◽

Mina Ouhamou ◽

Omar El Omari ◽

Jalal Doufik ◽

...

Keyword(s):

Menstrual Cycle ◽

Obsessive Compulsive Disorder ◽

Case Reports ◽

Menstrual Phase ◽

Obsessive Compulsive ◽

Statistical Manual ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Diagnostic And Statistical Manual ◽

The Relationship

The relationship between the menstrual cycle and mood disturbances has been described in the literature and is linked to changes in the secretion of sex hormones. Rare studies have reported the exacerbation of obsessions during menstruation, while no case reports the onset of premenstrual Obsessive-Compulsive Disorder (OCD). Nosographically, obsessive symptoms are not part of premenstrual syndrome, and no specification of the menstrual cycle for obsessive disorders was mentioned in DSM 5 (Diagnostic and Statistical Manual of Mental Disorders). We report a 39-year-old patient followed for panic disorder since adolescence, and who currently presents for obsessive symptoms that meet the diagnostic criteria for an obsessive-compulsive disorder, and which have the particularity of occurring exclusively during menstruation. Our case emphasizes the importance of establishing a new nosographic framework that takes into account the development of obsessive-compulsive symptoms related to the menstrual cycle. Keywords: Obsessive-compulsive disorder; menstruation cycle; nosography.

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POST-DURAL PUNCTURE HEADACHE AND RISK FACTORS IN WOMEN UNDERGOING CESAREAN SECTION WITH SPINAL ANESTHESIA

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.4.5 ◽

2019 ◽

pp. 37-43

Author(s):

Thi Minh Thu Pham ◽

Thi Hoang Yen Do ◽

Van Long Le ◽

Van Minh Nguyen ◽

Viet Ha Vo ◽

...

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Spinal Anesthesia ◽

Local Anesthesia ◽

Dural Puncture ◽

Insertion Site ◽

Moderate Pain ◽

Needle Size ◽

Post Dural Puncture Headache ◽

History Of

Objective: To estimate the incidence of post-dural puncture headache (PDPH) and risk factors in women underwent Cesarean section with spinal anesthesia. Materials and method: In a prospective descriptive study, parturients underwent Cesarean section with spinal anesthesia. Incidence of post-dural puncture headache, the history of spinal anesthesia and PDPH, presence of headache, preeclampsia, migraine, sinusitis, caffeine withdraw, insertion site, repeated puncture attempts, direction of the needle, size of the needle, local anesthesic, perioperative hypotension, nausea and vomiting, amount of intravenous fluid were recorded. Results: There were 389 patients in the study. The incidence of PDPH was 14.65% (mild and moderate pain: 75.44%; severe pain 21.05%; worst pain: 3.51%). The risk factors were history of PDPH (OR = 4.5; 95% CI: 1.8 - 11.09), sinusitis (OR = 2.65; 95% CI: 1.10 - 6.36), local anesthesia (Marcain spinal 0.5% heavy) (OR = 6.66; 95% CI: 2.25 - 19.11), perioperative hypotension (OR = 2.42; 95% CI: 1.25 - 4.70). Conclusion: The incident of PDPH in women undergoing Cesarean section with spinal anesthesia was 14.65%. Four risk factors were the history of PDPH, sinusitis, local anesthesia (Marcain spinal 0.5% heavy) and perioperative hypotension. Key words: post-dural puncture headache (PDPH), Cesarean section, spinal anesthesia

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