Die Bedeutung von Nadeltyp und Immobilisation für den postspinalen Kopfschmerz

Hafer, Jocelyn F.; Rupp, D.; Wollbrück, Matthias; Engel, Jutta; Hempelmann, G.

doi:10.1007/s001010050480

Cited by 37 publications

(9 citation statements)

References 11 publications

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“…Frauen scheinen zwar eher unter postspinalem Kopfschmerz zu leiden, als Männer [5,41,43]. Die Mehrzahl der klinischen Untersuchungen zeigt aber keine signifikante Abhängigkeit der Kopfschmerzinzidenz vom Geschlecht der Patienten [32,53,54]. [26].…”

Section: Geschlechtunclassified

“…Die Schmerzen sind häufig occipital oder frontal lokalisiert, können aber auch den ganzen Kopf betreffen. Als Begleitsymptome kommen Rücken-und Nackenschmerzen, Nackensteifigkeit, Übelkeit, Brechreiz, Schwindel [30,32] sowie Sehstörun-gen und Tinnitus vor [30], die in ihrer Gesamtheit das postpunktionelle Syndrom kennzeichnen. Typischerweise fehlen jedoch die Zeichen einer Meningitis [30].Auch die Begleitsymptome verstär-ken sich in ihrer Intensität bei Provokation des Kopfschmerzes.…”

Section: Introductionunclassified

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Postpunktioneller Kopfschmerz

et al. 1999

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Lumbar puncture (LP) is a routine technique performed for a variety of procedures, e.g. diagnosis, administration of drugs, myelography and spinal anaesthesia. Postdural puncture headache is a common complication (30-40% in diagnostic LP). Prevention can be accomplished by using small-gauge needles (< or = 25 G) or pencil-point needles (22 G). Therapy should be carried out in a stepwise approach. The first step is bedrest, use of analgetics, i.v. fluids and an adequate guidance of the patient. The second step comprises special drug therapy. Several methods of pharmacologic management have been presented in the literature, but most of these are case reports. There is a lack of large double-blind placebo-controlled studies. Theophylline, caffeine, ACTH and sumatriptan are potentially promising agents for the treatment of postdural puncture headache. The efficacy of theophylline has been proven in a double-blind and placebo-controlled study. There are a few studies and case reports reporting that caffeine p.o. and i.v. is effective in the treatment of postdural puncture headache, but recurrence of headache after caffeine therapy is frequent. ACTH acts on a complex hormonal system. The treatment with sumatriptan has been reported in only a few case reports. The third step, and one of the most effective treatments of postdural puncture headache, is the epidural blood patch. The success rate ranges between 80 and 97%.

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Section: Geschlechtunclassified

Section: Introductionunclassified

Postpunktioneller Kopfschmerz

et al. 1999

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“…Çalışmamızda, işlem sonrası ortaya çıkan başağrısı sorgulanmıştır. Başağrısı ile cinsiyet arasında anlamı bir ilişkinin olmadığını gösteren çalışmalara karşın, [27,28] Despond [29] ve Bridenbaugh [30] yaptıkları çalışmalarda, başağrısının kadınlarda daha yüksek oranda olduğunu bildirmişlerdir. Ghaleb tarafından yapılan bir çalışmada; kadınların özellikle hamileliğin ve vajinal doğumun başağrısı için artmış bir risk oluş-turduğu belirtilmiştir ve çalışmalarında %35 oranın-da başağrısı insidansı belirtmişlerdir.…”

Section: Discussionunclassified

Transient neurological symptoms after spinal anesthesia

Çetin¹,

Kayacan

Karsli³

2018

Agri

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SummaryObjectives: Transient neurological symptoms (TNS) after spinal anesthesia vary from dysesthesia that is hardly noticed to severe pain. The aim of this study was to determine the incidence of TNS and provocative risk factors in 591 patients who underwent central block. Methods: Before the operation, demographic data and features of the operation and the block were recorded. The patients were evaluated at postoperative 24 and 48 hours and day 7 with regard to TNS in the form of pain (headache, lower back and/or limb pain, backache, pain in the puncture region) and sensation disorders (paresthesia, hypoesthesia, hyperesthesia, anesthesia, dysesthesia). Results: The incidence of TNS among the study patients was 35.7%. It was significantly higher in gynecology and urology patients and was higher in female patients in comparison with male patients. The incidence of TNS was greater when blood in the needle/catheter, pain, or paresthesia was seen, but was not associated with LA agents used in the study. Conclusion: A similar TNS incidence was seen in the results of this study as has been reported in the literature. A greater number of attempts, the lithotomy position, and co-morbidities such as ASHD and DM increase the incidence of TNS.Keywords: Regional anesthesia; TNS; sensation disorder. ÖzetAmaç: Santral blok sonrası gözlenen GNS, hastaların zorlukla farkına varabildikleri dizesteziden, çok şiddetli ağrıya kadar oldukça değişken ve geniş şikayetler dizisini içermektedir. GNS sıklığını ve potansiyelize eden risk faktörlerinin belirlenmesini amaçlayan bu çalışmaya, santral blok uygulanan 591 hasta dahil edildi. Gereç ve Yöntem: Operasyon öncesi hastaların demografik bilgileri, operasyon ve uygulanan blok türüne ait özellikler kaydedildi. Hastalar postoperatif 24, 48 saat ve 7. günde GNS olarak ağrı (başağrısı, bel ve/veya bacak ağrısı, sırt ağrısı, girişim yeri ağrısı) ve duyu kusurları (parestezi, hipoestezi, hiperestezi, anestezi, dizestezi) açısından değerlendirildi. Bulgular: Çalışmaya katılan hastalarda GNS sıklığı, %35.7 olarak hesaplanırken, bu oran KHD, üroloji hastalarında anlamlı olarak yüksekti. GNS, kadın hastalarda erkek hastalara göre anlamlı olarak fazla bulundu. Santral blok uygulamaları sırasında iğne/ kateterden kan gelmesi, ağrı ve parestezi varlığında, GNS insidansında artma izlenirken, kullanılan LA ajanlar arasında, GNS insidansında farklılık bulunmadı. Sonuç: Çalışmamızda literatür bilgileriyle benzer GNS oranları bulduk. Artan ponksiyon sayısı, litotomi pozisyonu, eşlik eden ASKH ve DM gibi komorbid durumlar GNS insidansını artırmaktadır.Anahtar sözcükler: Duyu kusuru; GNS; rejyonal anestezi. 58NISAN -APRIL 2018

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“…Weitere in der Literatur diskutierte Einfluûfaktoren stellen die Punktionsrichtung im Verlauf zur Duratextur [8,22,28], ganz unzweifelhaft die Nadeldicke, die Anzahl der Punktionsversuche mit daraus resultierenden Duradefekten und auch die Nadelkonfiguration dar [9,16,32]. Sogenannte atraumatische Nadeln mit gerundeter Spitze sollen das Risiko minimieren [6,7,13,19,21,29]. Bettruhe als Prophylaxe hat sich nach neueren Daten als nicht erfolgreich erwiesen.…”

Section: Diskussionunclassified

“…Er betraf bevorzugt bestimmte Personengruppen, welche nach Lehrbuchaussagen prophylaktisch ausgeschlossen werden sollten. Eine weit verbreitete ¹Prophylaxeª ± 24 Stunden strenge Bettruhe -löste das Problem keineswegs, verminderte die Akzeptanz und schloû die Spinalanästhesie für die ambulante Chirurgie praktisch aus [1,3,13,32]. Sie wird mittlerweile als unangebracht erachtet.…”

Section: Introductionunclassified

Erfahrungen mit der G27 Whitacre Spinalnadel im stationären und ambulanten Bereich - - Inzidenz von postpunktionellen Kopfschmerzen und anderen Nebenwirkungen -

Jost¹,

Hirschauer²,

Dörsing³

et al. 2000

Anasthesiol Intensivmed Notfallmed Schmerzthe

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The use of a thin pencil point needle (Whitacre G27) enables the application of a spinal anaesthesia to young people with a low risk of moderate PDPH. Pregnancy is not a contraindication. Early mobilisation does not increase the risk of PDPH even in young patients nor is this the case in outpatients. In outpatients older than 60 years a G26 Quinke needle, which is easier to handle and cheaper, is suitable for spinal anaesthesia without a risk of PDPH. Better post-operative vigilance may be a further benefit of the method. Young people especially appreciated the option to pursue their own video-endoscopic surgery. In a comparable group where an epidural was performed we found more side-effects.

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Die Bedeutung von Nadeltyp und Immobilisation für den postspinalen Kopfschmerz

Cited by 37 publications

References 11 publications

Postpunktioneller Kopfschmerz

Postpunktioneller Kopfschmerz

Transient neurological symptoms after spinal anesthesia

Erfahrungen mit der G27 Whitacre Spinalnadel im stationären und ambulanten Bereich - - Inzidenz von postpunktionellen Kopfschmerzen und anderen Nebenwirkungen -

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