post-dural puncture headache: a comparison between median and paramedian approaches in orthopedic patients
نویسندگان
چکیده
conclusions there is no difference between median and paramedian approaches with respect to pdph incidence; the paramedian approach is therefore recommended, especially for older patients with degenerative changes in the spine and intervertebral spaces and those who cannot take the proper position. moreover, the rate of pdph was found to be significantly higher in females than in males. results fifteen patients (10%) developed pdph. there was no significant difference in the incidence of pdph in both groups, with 7 (9.3%) patients in the median approach group versus 8 (10.7%) in the paramedian approach group developing typical pdph (p = 0.875). however, a significant difference in pdph incidence (p = 0.041) was observed between females (9; 16.7%) and males (6; 6.3%). patients and methods patients scheduled for orthopedic surgery under spinal anesthesia between 2007 and 2008 were studied in a double-blinded randomized controlled trial. the patients were randomized to receive spinal anesthesia by either a median (n = 75) or paramedian (n = 75) approach through a 25-gauge crawford needle. no premedication was given, and all patients received 500 ml of normal saline intravenously and 4 ml of 0.5% isobaric marcaine 30 minutes prior to surgery in both approaches. objectives in this study we aimed to compare the incidence of pdph in the case of median and paramedian approaches in patients undergoing spinal anesthesia for orthopedic operations. background post-dural puncture headache (pdph) is an iatrogenic complication of spinal anesthesia. reported risk factors for pdph include sex, age, pregnancy, needle tip shape and size, bevel orientation, approach and others. little is known regarding the effect of different approaches on the incidence of pdph.
منابع مشابه
Post-dural Puncture Headache: A Comparison Between Median and Paramedian Approaches in Orthopedic Patients
BACKGROUND Post-dural puncture headache (PDPH) is an iatrogenic complication of spinal anesthesia. Reported risk factors for PDPH include sex, age, pregnancy, needle tip shape and size, bevel orientation, approach and others. Little is known regarding the effect of different approaches on the incidence of PDPH. OBJECTIVES In this study we aimed to compare the incidence of PDPH in the case of ...
متن کاملPost-Dural Puncture Headache
August Bier’s first report of spinal anesthesia in August 1898 impressively described the development of a poste dural puncture headache (PDPH) (1). When asked for complications of spinal anesthesia today, patients often respond with PDPH. PDPH is defined as a constant heado ache that worsens in the sitting or upright position folglowing lumbar puncture (LP). Its incidence after spinal anesthes...
متن کاملPost-dural puncture headache
Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge ...
متن کاملPost-dural puncture headache [Retraction]
[This retracts the article on p. 45 in vol. 5, PMID: 22287846.].
متن کاملOnce a post-dural puncture headache patient always post-dural puncture headache patient?
It is well known that symptoms of post-dural puncture headache (PDPH) are more likely if there has been a preceding PDPH. We herein present a patient who developed a PDPH following each of two dural punctures separated by 9 years.
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عنوان ژورنال:
anesthesiology and pain medicineجلد ۱، شماره ۲، صفحات ۶۶-۶۹
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