scholarly journals Epidural Filling with Crystal-colloid Solution for Post Accidental Dural Puncture Headache: A Case Series

2021 ◽  
Vol 44 (2) ◽  
pp. E44-47
Author(s):  
Jin Yu ◽  
Min An ◽  
Wenjie Wu ◽  
Youchang Li ◽  
Chaowen Liu
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Case Series ◽  
Epidural Injection ◽  
Colloid Solution ◽  
Median Frequency ◽  
Cesarean Sections ◽  
Post Dural Puncture Headache ◽  
Accidental Dural Puncture ◽  
Women And Children

Purpose: Post dural puncture headache (PDPH) is a common anesthetic complication caused by expected spinal puncture or accidental dural puncture during intraspinal anesthesia operation. The purpose of this study was to retrospectively analyze the clinical features and outcomes of parturients with accidental dural punctures (ADP). Methods: (All cesarean sections at the Chongqing Health Center for Women and Children (Chongqing, China) carried out under neuraxial anesthesia from January 1, 2017 to December 31, 2018 were reviewed and data from 20 parturients with ADP were collected and analyzed. Results: Seventeen individuals received crystal-colloid solution fillers and three did not. The median epidural catheter retaining time was 40 hours; the median frequency of epidural filling was three times, with a median total volume of 60 ml. One patient developed tinnitus and three complained of head swelling during filling. The median bed-stay duration was 73 hours, with total intravenous infusion volume of 7.3 L in the first three postoperative days. Two patients complained of slight dizziness and mitigation, and five felt weak. One individual had intermittent headaches and dizziness till the seventh postoperative day. Conclusions: Epidural injection of crystal-colloid solution, combined with hydration, maybe a useful preven-tive strategy for ADP-induced headache after cesarean section.

scholarly journals Epidural filling with crystal-colloid solution prevented accidental dural- puncture-induced headache after cesarean section

2019 ◽  
Author(s):  
Jin Yu ◽  
Min An ◽  
Ya Yan ◽  
Youchang Li ◽  
Chaowen Liu
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Epidural Injection ◽  
Average Frequency ◽  
Colloid Solution ◽  
Preventive Strategy ◽  
Average Volume ◽  
Post Dural Puncture Headache ◽  
Accidental Dural Puncture ◽  
Effective Preventive Strategy

Abstract Background: Post dural puncture headache (PDPH) is a common anaesthetic complication caused by spinal puncture or accidental dural puncture during intraspinal anesthesia operation. There is no panacea, either preventive or therapeutic for PDPH. Methods: This study retrospectively collected and analyzed data on the clinical features and outcomes of 20 puerperants with accidental dural punctures. Seventeen individuals received crystal-colloid solution fillers and three did not. Results: The average epidural catheter retaining time was 35.97 hours; the average frequency of epidural filling was 2.65 times, with an average volume of 65.88 ml per fill. One patient developed tinnitus and three complained of head swelling during filling. The average bed-stay was 72.65 hours, with intravenous infusion volume of 2308.82 ml per day in the first three postoperative days. Two patients complained of slight dizziness and mitigation, and five felt weak. One individual had intermittent headaches and dizziness till the seventh postoperative day. Conclusions: Epidural injection of crystal-colloid solution combined with hydration is an effective preventive strategy for PDPH after cesarean section based on this observational study.

scholarly journals Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial

2019 ◽  
Vol 7 (4) ◽  
pp. 549-552 ◽  
Author(s):  
Mhamed Abdelraouf ◽  
Maged Salah ◽  
Mohsen Waheb ◽  
Ahmed Elshall
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Controlled Trial ◽  
Demographic Data ◽  
Visual Analogue Score ◽  
Control Group ◽  
Neck Muscle ◽  
Rescue Analgesia ◽  
Post Dural Puncture Headache ◽  
Control Group Group

INTRODUCTION: Post-dural puncture headache (PDPH) is a common complication following neuraxial anaesthesia that increases the duration of hospital stay. AIM: This study aims to evaluate the effectiveness of injection of the dexamethasone-lidocaine mixture in suboccipital muscles treatment of PDPH after cesarean section. PATIENT AND METHODS: A group of 90 females with PDPH following cesarean section under spinal anaesthesia were randomly allocated into two equal groups: study group (Group S) and control group (group C). All patients received bilateral intramuscular (in the suboccipital muscle) (Group S) (n = 45) patients received lidocaine 40 mg (2 mL of 2% solution) and dexamethasone 8mg in a total volume of 4 mL; whilst, patients in the control group (group C) (n = 45) received 4 mL normal saline. The primary outcome is the Visual Analogue Score for a headache at 24 hours after injection. RESULTS: Demographic data and the baseline, headache score, neck muscle spasm, and nausea were comparable in both groups. Group S showed lower headache score compared to group C at all the post-injection time points. All patients in group S showed resolution of nausea after the intervention; while none of the control group showed any improvement. All patients of group C needed rescue analgesia; while only 6 (13.3%) patients in group S asked for an analgesic. Time to the first analgesic request was longer in group S compared to group C (10.17 ± 7.96 hours versus 1.00 ± 0.00 hours, P < 0.001). CONCLUSION: Ultrasound-guided injection of the dexamethasone-lidocaine mixture in suboccipital muscles is effective management of PDPH after CS.

scholarly journals Comparison of the effects of sagittal versus transvers 25-gauge quincke needle insertion on post-dural puncture headache development

2020 ◽  
Vol 7 (7) ◽  
pp. 554-559
Author(s):  
Mehmet Tercan ◽  
Tuğba Bingöl Tanrıverdi ◽  
Gülçin Patmano ◽  
Ahmet Atlas ◽  
Ahmet Kaya ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Dura Mater ◽  
Dural Puncture ◽  
Multivariate Logistic Regression Analysis ◽  
Needle Insertion ◽  
Spinal Needle ◽  
Post Dural Puncture Headache ◽  
Spinal Puncture ◽  
American Society

Objective: Post-dural puncture headache (PDPH) is one of the most important complications after spinal anesthesia. This study aimed to investigate the effect of the sagittal or transverse application of 25-gauge Quincke spinal needle on PDPH development in patients undergoing cesarean section. Material and Methods: A total of 295 patients with a planned cesarean section between the ages of 18-40 years with an American Society of Anesthesiologists score of 1 or 2 were included in the study. For the spinal intervention, 25-gauge Quincke spinal needle was used in all patients. Patients were included in one of two groups according to the spinal needle cutting direction of the dura mater fibers as sagittal (parallel to dura mater fibers, Group S; n=145) or transverse group (perpendicular to dura mater fibers, Group T; n=150). Results: PDPH developed in 27 (9.2%) patients. Patients in Group T had significant higher ratio of PDPH compared to patients in Group S (16% vs. 2.1%, p<0.001). Additionally, patients with PDPH had a significantly higher frequency of ≥2 spinal puncture attempts compared to patients without PDPH (22.2% vs. 4.5%, p=0.003). Multivariate logistic regression analysis demonstrated that transverse needle direction (OR: 11.40, 95% CI: 2.73-34.71; p<0.001) and ≥2 spinal puncture attempts (OR: 9.73, 95% CI: 3.13-41.55; p<0.001) and were independent predictors for PDPH development. Conclusion: Transverse insertion of the 25-gauge Quincke needle into spinal cord fibers and repeated interventions are independently associated with the development of PDPH in cesarean section patients undergoing spinal anesthesia

scholarly journals Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial

2021 ◽  
pp. E443-E451
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Nerve Blocks ◽  
Neck Stiffness ◽  
Post Dural Puncture Headache ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Blood Patch

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

scholarly journals Punção Acidental da Dura e Cefaleia Pós-punção da Dura na População Obstétrica: Oito Anos de Experiência

2016 ◽  
Vol 29 (4) ◽  
pp. 268
Author(s):  
Maria Vaz Antunes ◽  
Adriano Moreira ◽  
Catarina Sampaio ◽  
Aida Faria
Keyword(s):  
Conservative Treatment ◽  
Epidural Catheter ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Spinal Block ◽  
Post Dural Puncture Headache ◽  
Retrospective Audit ◽  
Prophylactic Measures ◽  
Blood Patch ◽  
Accidental Dural Puncture

<p><strong>Introduction:</strong> Accidental dural puncture is an important complication of regional anesthesia and post-dural puncture headache remains a disable outcome in obstetric population. The aim of our study was to calculate the incidence of accidental puncture and post-puncture headache and evaluate its management among obstetric anesthesiologists.<br /><strong>Material and Methods:</strong> We conducted a retrospective audit, between January 2007 and December 2014. We reviewed the record sheets of patients who experienced either accidental puncture or post-puncture headache. We excluded the patients undergoing spinal block. We use the SPSS 22.0 for statistical analyses.<br /><strong>Results:</strong> We obtained 18497 neuro-axial blocks and 58 accidental dural punctures (0.3%). After detected puncture, in 71.4% epidural catheter was re-positioned and 21.4% had intra-thecal catheters. Forty-five (77.6%) developed headache and the prophylactic measures were established in 76.1%. Conservative treatment was performed in all patients. The epidural blood patch was performed in 32.8% with a 84.2% of success.<br /><strong>Discussion:</strong> The incidence of post-dural puncture headache is unrelated to the type of delivery or insertion of intrathecal catheter. The re-placement of the epidural catheter remains the main approach after puncture. The institution of prophylactic measures is a common practice, despite the low level of evidence. We performed epidural blood patch after failure of conservative treatment.<br /><strong>Conclusion:</strong> The incidence of accidental dural puncture and post-dural puncture headache was similar to the literature. Despite being a common complication, there remains lack of consensus on its approach.</p>

Management of accidental dural puncture and post-dural puncture headache after labour: a Nordic survey

2010 ◽  
Vol 55 (1) ◽  
pp. 46-53 ◽  
Author(s):  
B. DARVISH ◽  
A. GUPTA ◽  
S. ALAHUHTA ◽  
V. DAHL ◽  
S. HELBO-HANSEN ◽  
...  
Keyword(s):  
Dural Puncture ◽  
Post Dural Puncture Headache ◽  
Accidental Dural Puncture
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