scholarly journals The Sprotte Needle and Post Dural Puncture Headache following Caesarean Section

1993 ◽  
Vol 21 (3) ◽  
pp. 280-283 ◽  
Author(s):  
A. W. Ross ◽  
C. Greenhalgh ◽  
D. P. McGlade ◽  
I. G. Balson ◽  
S. C. Chester ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Population Size ◽  
Lower Incidence ◽  
Dural Puncture ◽  
Operating Conditions ◽  
Hyperbaric Bupivacaine ◽  
Post Dural Puncture Headache ◽  
The Difference ◽  
Obstetric Population

One hundred and forty-four patients receiving subarachnoid anaesthesia for caesarean section were prospectively analysed for quality of anaesthesia and the occurrence of post dural puncture headache (PDPH). Anaesthesia was administered via 24 gauge Sprotte (n = 104) and 26 gauge Quincke (n = 40) needles using hyperbaric bupivacaine 0.5% with morphine 0.2 mg. Anaesthesia was successful in 103 patients with the Sprotte needle and 38 patients with the Quincke needle, and the operating conditions were considered to be excellent. Of the 104 patients in the Sprotte needle group there were ten with PDPH (9.6%), two of which were considered severe. Of the 40 patients in the Quincke needle group there were eight with PDPH (20%), three of which were considered severe. Despite the lower incidence of headache in the Sprotte needle group, this was not statistically significant (P>0.05), due to the difference in population size. We conclude that the 24 gauge Sprotte needle is associated with a comparatively low but clinically relevant incidence of headache in the obstetric population.

scholarly journals The spinal adjuvent - intrathecal nalbuphine as effective as intrathecal fentanyl

2020 ◽  
Vol 11 (3) ◽  
pp. 4492-4498
Author(s):  
Pratibha Deshmukh ◽  
Medha Sangawar ◽  
Nikita Dhumne ◽  
Vivek Chakole
Keyword(s):  
Dural Puncture ◽  
Local Anaesthetics ◽  
Hyperbaric Bupivacaine ◽  
Time Duration ◽  
Post Dural Puncture Headache ◽  
Intraoperative Hypotension ◽  
Number Of Patients ◽  
Significant Difference ◽  
To Receive

Opioids are favoured as adjuvants to local anaesthetics for spinal anaesthesia. The present study was aimed to compare the clinical efficiency of intrathecal nalbuphine with fentanyl as an adjuvant to 0.5% hyperbaric bupivacaine. 100 adult patients of either sex, ASA grade I and II, aged 18–60 years were randomized into two groups of 50 each to receive either fentanyl 25 μg (Group BF) or nalbuphine 500µg (Group BN) with 3 ml 0.5% hyperbaric bupivacaine, making drug volume to 3.5 ml in each group. Sensory and motor block characteristics, duration of analgesia, VAS score, haemodynamic and side effects were recorded. The sensorimotor characteristics were comparable and found no significant difference between the two groups, (P>0.05). The time duration for adequate analgesia in group BN was 366.40 ± 37.32min, and in the group, BF was 361.39 ± 43.96min, (P= 0.567). In both, the groups, quality of analgesia during the procedure was excellent in a maximum number of patients (96% each group). Sedation score, hemodynamic and respiratory rate changes were comparable between the two groups. In group BF, 4 (8%) patients complained nausea/ vomiting, pruritus was observed in 2 (4%), intraoperative hypotension in 3 (6%) and bradycardia in 2 (4%) and post-dural puncture headache in 2 patient (4%). In group BN, only bradycardia was observed in 3 (6%) patients. Nalbuphine and fentanyl were found to be equally efficient, but nalbuphine had a lower side effect profile, readily available as it does not come under the Narcotic act. However, we suggest Nalbuphine-bupivacaine combination as a better alternative than fentanyl-bupivacaine combination.

scholarly journals COMPARISON OF OCCURRENCE OF POST DURAL PUNCTURE HEADACHE IN LOWER SEGMENT CAESAREAN SECTION UNDER SUBARACHNOID BLOCK BY MEDIAN VS PARAMEDIAN APPROACH: A RANDOMIZED INTERVENTIONAL STUDY

2021 ◽  
Vol 9 (01) ◽  
pp. 551-558
Author(s):  
Suman K. Dabi ◽  
◽  
Vandana Mangal ◽  
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Time Duration ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
The Difference ◽  
Mean Time

Aims: Spinal anaesthesia is a standard anesthetic technique in obstetrics, as it provides good analgesia and muscle relaxation. But every procedure comes with certain side effects and complications. Lumbar puncture for subarachnoid block is done by either median or paramedian approach. Besides postoperative headache, other side effects like nausea, vomiting have been reported in the postoperative period. Hereby we conducted a study on patients undergoing lower segment caesarean section (LSCS) under spinal anaesthesia by either median or paramedian approach, and compared the occurrence of post dural puncture headache in both groups. Methods and Material: 400 parturients of ASA grade I & II who underwent LSCS under spinal anaesthesia were divided into two groups: Group M (n=200) received spinal block by median approach while Group PM (n=200) received by paramedian approach. We observed the difference in proportion of cases who develop post dural puncture headache (PDPH) in both study groups and also to determine the difference in mean time duration of development of PDPH in both groups. Statistical analysis used:The data was analysed by using chi-square and T-test where p<0.05 was considered as statistically significant Results: 5 patients (2.5%) in group M developed PDPH whereas only 1 patient(0.5%) in group PM developed PDPH which was statistically non-significant (p=0.099). The mean time duration of onset of PDPH was similar in both groups. Conclusions:Hence from our observations we conclude that there is no statistically significant difference in the incidence of occurrence of PDPH when lumbar puncture is done with 25 G by either median or paramedian approach.

scholarly journals Assessment of vehicle brake control functional stability

2021 ◽  
Vol 12 (2) ◽  
pp. 33-44
Author(s):  
Volodymyr Volkov ◽  
◽  
Igor Gritsuk ◽  
Tetiana Volkova ◽  
Volodymyr Kuzhel ◽  
...  
Keyword(s):  
Energy Consumption ◽  
Control Method ◽  
Operating Conditions ◽  
National Standards ◽  
Passenger Vehicles ◽  
The Difference ◽  
Braking Control ◽  
The Stability ◽  
Friction Surfaces

The article is devoted to the study of the influence of the brake control elements of passenger vehicles on the stability of their braking properties. The analysis of the influence of uneven braking forces on the wheels of one axle of vehicles on the deviation of the distribution of braking forces between the axles from its calculated value is carried out. When assessing the error in regulating the distribution of braking forces between the axles of vehicles, three components were taken into account: the theoretical error due to the imperfection of the selected control method (the difference between the actual calculated control characteristic from the ideal), the error created due to the instability of the ratio of the braking forces on the front and rear wheels, an additional error caused by the unevenness of the braking forces on the wheels of individual axles, since the fulfillment of the most stringent requirements of international and national standards for the efficiency of braking of vehicles and is inextricably linked with the need to increase the energy consumption of brake mechanisms. The energy consumption of braking mechanisms is understood as the ability of the latter to dissipate the greatest amount of energy of the braking machine without reducing the braking efficiency indicators to the minimum permissible level. Excessive heating of the braking mechanisms leads to a decrease in the friction coefficient μ of the friction surfaces and increased wear of the friction linings, and the brakes are the most unstable element of the braking control, which ensures the absorption and dissipation of the vehicle's energy during braking. The instability of the braking torques on the front and rear wheels, caused by a change in the coefficients of friction of friction pairs, leads not only to a change in the distribution of braking forces between the axles and individual wheels, but also to a decrease in the braking efficiency of vehicles under operating conditions. A method is proposed that makes it possible to assess the quality of regulation of the distribution of braking forces between the axles of a car, taking into account the instability of the braking forces on the wheels.

scholarly journals Incidence of post dural puncture headache in parturients following early ambulation and recumbency

2017 ◽  
Vol 4 (2) ◽  
pp. 14-20
Author(s):  
Niroj Hirachan
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Muscle Relaxation ◽  
Early Mobilization ◽  
Chi Square ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Chi Square Test ◽  
Group A

Introductions: Spinal anesthesia is a safe and acceptable technique for patients undergoing caesarean section because it provides both excellent analgesia and muscle relaxation. Post Dural Puncture Headache (PDPH) is frequently reported complication after spinal anesthesia. This study evaluates the incidence of PDPH following early mobilization and recumbency after caesarean section. Methods: This prospective, randomized comparative interventional study included 100 parturients women of age 18 to 45 years, ASA I and II, randomly divided into two groups – Ambulatory ‘A’ and Recumbent ‘R’. At the end of caesarean section, patients were advised to either lie in recumbent position for 24 hours or mobilize as soon as they become ambulatory after spinal aneshthesia. Occurrence of headache were recorded at 24 hours, 72 hours and 7th day. Software SPSS 16, chi-square test was used for proportions like incidence and severity of PDPH; p<0.05 was taken as significant. Results: The incidence of PDPH was statistically not different (p = 0.361) in Group R 8% (4 patients) and in Group A 6% (3 patients). In both the groups, the severity of headache was mild to moderate with only mild headaches in the Group A (p = 0.549). Conclusions: Early ambulation following spinal anesthesia for caesarean section did not increase the incidence of PDPH in parturients.  

scholarly journals Effect of pre-administration with aminophylline on the occurrence of post-dural puncture headache in women undergoing caesarean section by combined spinal-epidural anaesthesia

2018 ◽  
Vol 47 (1) ◽  
pp. 420-426
Author(s):  
Chao-Jie Yang ◽  
Tao Chen ◽  
Xin Ni ◽  
Wan-You Yu ◽  
Wei Wang
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Dural Puncture ◽  
Demographic Data ◽  
Operation Time ◽  
Post Dural Puncture Headache ◽  
Combined Spinal Epidural ◽  
Group A ◽  
Spinal Epidural

Objective To investigate the effect of the pre-administration with aminophylline on the occurrence of post-dural puncture headache (PDPH) in women undergoing caesarean section by combined spinal-epidural anaesthesia (CSEA). Methods The study enrolled women undergoing elective caesarean sections with CSEA and randomly allocated them into two groups; for 30 min immediately after the infant was delivered, group A received 250 mg aminophylline intravenously and group B received an equal volume of normal saline. Demographic data, operation time, intraoperative blood loss, intraoperative transfusion volume and the occurrence of PDPH during the first 7 days after the operation were recorded. Side-effects such as hypersensitivity, convulsion and arrhythmia were also recorded in the patients and infants in group A within 24 h after aminophylline administration. Results A total of 120 patients aged 24–38 years (pregnancy range, 38–42 weeks) were randomly allocated into two groups ( n = 60). The incidence of PDPH in group A was significantly lower than group C (two of 59 [3.4%] versus 10 of 58 [17.2%], respectively). There were no related side-effects within 24 h after aminophylline administration in group A. Conclusions Intraoperative intravenous infusion of 250 mg aminophylline reduced the incidence of PDPH after caesarean section under CSEA with no side-effects.

scholarly journals To Compare the Incidence of Post-Dural Puncture Headache Using 25G Quincke and 25G Whitacre Spinal Needles in Patients Undergoing Lower Segment Caesarean Section

2021 ◽  
Vol 10 (14) ◽  
pp. 1014-1019
Author(s):  
Aditya Rameshbabu Devalla ◽  
Sanjot S. Ninave ◽  
Amol P. Singam
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
Key Words Spinal Anaesthesia ◽  
American Society ◽  
Obstetric Surgery

BACKGROUND Spinal anaesthesia is the first preference of anaesthesia in obstetric surgery. Post dural puncture headache (PDPH) is more common after C-section in young parturients. In the present world which is developing and fast-paced, brisk recovery along with minimal side effects & importantly early ambulation are now the need of the hour. This headache is more worrying to the mother who is required to tend to the newborn baby. This study compared the incidence of PDPH subsequent to subarachnoid blockade for lower segment Caesarean section (LSCS) 25G Whitacre & 25G Quincke needles. We wanted to compare the incidence of PDPH using 25G Quincke and 25G Whitacre spinal needles in patients undergoing LSCS. METHODS Two hundred (ASA II) American Society of Anaesthesiologists 11 females who were pregnant and in the age group of 20 - 50 years, planned to get sub-arachnoid blockade for C-section, were assigned randomly into two equal groups (N = 100 each). Both groups received spinal anaesthesia with 25-gauge Quincke and 25 gauge Whitacre needle. Postoperatively, incidence, site, onset, severity and duration of headache was studied. RESULTS The incidence of post spinal headache was 6 % in the Quincke group. No patients in Whitacre group had PDPH. The number of lumbar punctures required for successful sub arachnoid block was recorded in both the groups. 92 % patients from group Q and 88 % patients from group W required only one puncture. 8 % patients from group Q and 12 % patients from group W required two punctures. CONCLUSIONS It is prudent to conclude that 25G Whitacre spinal needle is a better alternative to 25G Quincke needle for reducing the incidence of post dural puncture headache in patients undergoing lower segment Caesarean section. KEY WORDS Spinal Anaesthesia, Post Dural Puncture Headache, Caesarean Section

scholarly journals COMPARISON OF HAEMODYNAMIC STABILITY WITH 0.5% AND 0.75% HYPERBARIC BUPIVACAINE DURING SPINAL ANAESTHESIA IN WOMEN UNDERGOING CAESAREAN SECTION

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
The Mean ◽  
The Difference

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.

Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Chi Square Test ◽  
Randomized Control ◽  
Group Ii ◽  
The Difference

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

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