Effect of Subarachnoid Morphine on the Incidence of Spinal Headache

Abboud, T. K.; Miller, Hyman; Afrasiabi, A.; Zhu, Judy; Steffens, Z.; Sherman, Gary; Reyes, A.; Afrasiabi, K.; Amershad, B.

doi:10.1097/00132586-199210000-00022

Cited by 8 publications

(8 citation statements)

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“…Simple analgesics such as acitamenophen and NSAIDS may provide some benefit. [37][38][39] In our study 82.6 % (19) patients responded well to bed rest and increased oral fluid intake, no specific oral/ parenteral analgesics were given to our patients and none of them required aggressive management like blood patching which is similar to the study done by Agarwal et al and Dagmar Oberhofer et al 22,23 A Norwegian study done in 1985, by Flaaten and Raeder, their 2 patients required treatment of PDPH by blood patch. 15 Another study done by Almeida et al, their 3 patients out of 38 required epidural blood patch.…”

Section: Discussionsupporting

confidence: 79%

Incidence of Post Dural Puncture Headache in Spinal Anaesthesia for Cholecystectomy

Fatimah¹,

Haq²,

Hilal³

et al. 2014

J Pharm Sci Innov.

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Post dural puncture headache is a significant and well known complication of puncture of the duramater. Historical reference to Post dural puncture headache was recorded by August Bier in 1899. There is a direct correlation between needle size and risk of Post dural puncture headache. This study comprised of 200 ASA grade I and II patients between 15 to 74 years of age of both sexes who underwent elective cholecystectomy. After undergoing a thorough preanaesthetic check up each patient received pre-medication one night before surgery and skin sensitivity test was done. Patient was kept nil orally, a baseline pulse rate, blood pressure and oxygen saturation were recorded. Lumbar puncture was done in sitting position at L2-L3 inter vertebral space with Quincke needle (23, 25, 26 G). After assuring a free flow of clear cerebrospinal fluid 4 ml of 0.5 % bupivacaine heavy was injected. After achieving satisfactory block patients were oxygenated by face mask and regular monitoring of pulse rate, blood pressure and oxygen saturation was done and recorded. Statistical analyses was done by applying students 't' test. The mean age of the patient was 41.2 ± 12.2 years and female patients outnumbered their male counterparts (87.5 %). 25G needle was used in maximum number of patients. The incidence of Post dural puncture headache with 23, 25, 26 G was 24.3 %, 9.2 %, 4.1 % respectively. On statistical analysis the Post dural puncture headache was significantly higher with 23G needle as compared to 25 or 26G (p < 0.05). However there is no statistical significance between 25 and 26G needles. The study concluded that the incidence of post dural puncture headache can be reduced to minimum with the use of small sized needles and proper technique of spinal anaesthesia by an experienced anaesthesiologist.

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Section: Discussionsupporting

confidence: 79%

Incidence of Post Dural Puncture Headache in Spinal Anaesthesia for Cholecystectomy

Fatimah¹,

Haq²,

Hilal³

et al. 2014

J Pharm Sci Innov.

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“…The holes in the dura and subarachnoid are less likely to overlap, thereby reducing the risk of CSF leakage [16]. Finally, there are conflicting reports as to the prophylactic effect of epidural or spinal opioids against PDPH [24][25][26].…”

Section: Postdural-puncture Headachementioning

confidence: 99%

Recent advances in obstetric anesthesia

Farragher

Datta

2003

Journal of Anesthesia

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The low-dose technique of combined spinal/epidural analgesia is to be welcomed in obstetrics. Its merits include rapid onset of analgesia, with the flexibility of an epidural technique, and high maternal satisfaction. It is a safe and effective technique. Pulse oximetry should be employed when using intrathecal opioids. Commercially available combined-needle devices may make this technique more attractive to users. The role of spinal anesthesia for emergency cesarean section in severe preeclampsia has been reevaluated recently. We consider it a feasible option for those severely preeclamptic women requiring urgent cesarean section who do not have an epidural catheter in place. The choice of anesthetic technique for this patient population should be made on clinical judgment and not on anticipated hemodynamic changes. Spinal anaesthesia for cesarean section is associated with hypotension; however, certain interventions may reduce the incidence and severity of the hypotension. An increase in cardiac output appears to be key in attenuating the hypotensive response to spinal anesthesia. Colloids have exhibited most success in this regard. At our institution, we do not delay spinal anesthesia for urgent cesarean section in order to administer a predetermined volume of fluid; in such cases, we simultaneously administer a fluid preload and spinal anesthesia. Recent studies regarding the use of cell savers for blood conservation in obstetrics are based on small numbers of patients. These studies show great promise, particularly with the modern emphasis on avoiding blood transfusion, which can be massive in this usually young patient population.

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“…PSPH intensity was measured for 3 days and its prevalence was tested for 2 weeks. However, the results revealed no significant differences between the two groups based on PSPH intensity and incidence at the mentioned times (19). Conversely, Martlew reported that a total of 5173 patients received spinal anesthesia for C-section during the audit period, of whom 4559 subjects were followed up, postoperatively.…”

Section: Discussionmentioning

confidence: 83%

The Effect of Ginger on Preventing Post-spinal Puncture Headache in Patients Undergoing Cesarean Section

Mashak

Hashemnejad

Kabir

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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Objectives: Post-spinal puncture headache (PSPH) has constantly been one of the research priorities, especially in women undergoing cesarean section (C-section) and it is related to physical and psychological problems. The present study aimed to evaluate the effect of ginger on preventing PSPH in patients undergoing C-section. Materials and Methods: This clinical trial was conducted on 160 women undergoing C-section with spinal anesthesia, who were eligible to enter the study in the experimental and control groups. One ginger capsule (250 mg) was prescribed every 8 hours (TDS) to the experimental group 24 hours before the C-section. The prescription of ginger was continued half an hour after transfer to the post-partum ward until the PSPH onset. PSPH intensity was measured by using visual analog scale (VAS) pain scores at 6 timepoints (Time 1=30, Time 2=60, and Time 3=90 minutes vs. Time 4=3, Time 5 =6, and Time 6=12 hours) after C-section. No interventions were performed in the control group. The data were analyzed using the SPSS software by descriptive statistics and analytical tests were applied to determine the changes in PSPH intensity. Results: The comparison results of the mean score of PSPH intensity in the experimental and control groups indicated significant differences over time (P<0.05), except for the sixth time point (12 hours after C-section). In addition, the trend of changes at 6 timepoints based on the results of the repeated-measures test demonstrated that PSPH intensity significantly differed in the two groups over time (P<0.001). Conclusions: Based on the result, the oral prescription of ginger to women undergoing C-section under spinal anesthesia led to effective PSPH prevention at 5 time-points (30, 60, and 90 minutes, along with 3 and 6 hours). Further, the trend of the changes represented that the intensity of PSPH decreased in the experimental group over time. Therefore, ginger is suggested as a noninvasive and efficient method used for preventing PSPH.

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Effect of Subarachnoid Morphine on the Incidence of Spinal Headache

Cited by 8 publications

References 0 publications

Incidence of Post Dural Puncture Headache in Spinal Anaesthesia for Cholecystectomy

Incidence of Post Dural Puncture Headache in Spinal Anaesthesia for Cholecystectomy

Recent advances in obstetric anesthesia

The Effect of Ginger on Preventing Post-spinal Puncture Headache in Patients Undergoing Cesarean Section

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