Postoperative headache in young patients after spinal anaesthesia

Rodt, S. Å.; Rosland, Jan Henrik; Vamnes, Jan Sverre

doi:10.1111/j.1365-2044.1987.tb03001.x

Cited by 83 publications

(56 citation statements)

References 10 publications

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“…16 Many of the headaches that occur after spinal anaesthesia may not be the result of dural puncture and should be differentiated from the PDPHs by the patient's history. 13,25 The relatively high rate of PDPH that we describe for both spinal needles requires explanation. When the present study is compared with others using the 27 gauge Quincke needle, it appears that the patients in the present study were younger and followed up more closely than those reported by Flanagan et al 1 (PDPH rate of 3.7%).…”

Section: Discussionmentioning

confidence: 89%

“…,-4 Previously, we reported a PDPH rate of 19.6% in patients less than 40 yr of age using the 27 gauge Quincke needle. 5 The reported PDPH rates vary considerably, for example, PDPH rates for the 25 gauge Quincke needle range from 7.8% to 37.2%, 13,15,[17][18][19][20][21][22][23] and between 2% and 9.6% for the 26 gauge Quincke needle. 2,15,~9,24-27 While use of the 29 gauge Quincke needle has been reported to result in an incidence of PDPH between 0% and 2%, the failure rate of between 1.2% and 8% may make its use impractical.…”

Section: Discussionmentioning

confidence: 99%

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Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

1993

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

1993

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“…The rate of CSF loss through the dural perforation (0.084-4.5 ml s -1 ) is generally greater than the rate of CSF production (0.35 ml min -1 ), specially with needle sizes larger than 25G. 2 The incidence of PDPH a <2% with a 29G needle; 2%-12% with a 26G Quincke needle; ~25% with a 25G needle; 3,4 40% with a 22G needle and PDPH is usually a self-limiting process, but Vandam and Dripps in 1956 reported that 72% of headaches resolved within a week 5 . PDPH usually responds to increased fluid intake, bed rest and analgesics.…”

Section: Discussion-mentioning

confidence: 99%

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Paswan¹

2012

iosrphr

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-Tracheal stenosis is the most common late airway complication of post intubation/trachestomy resulted in hemodynamic deterioration and impairment of respiratory system mechanics. Post-dural puncture headache (PDPH) is well known complication of introduction of spinal/epidural needle in subarachanoid space. In this article, we present a very rare case report of a patient 18 year old male, diagnosis tuberculous meningitis(TBM) get prolong mechanical ventilation and dural puncture had developed tracheal stenosis and post-dural puncture headache . We describe a patient with PDPH and tracheal stenosis which was initially misdiagnosed as simple headache and asthma after prolonged tracheal intubation. Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. KEY WORD:-TBM .PDPH .TRACHEAL STENOSIS CASE HISTORY:-A 18 year-old male who presented with a 6-week history of headache and fever and a 8-hour history of inability to speak and alteration in level of consciousness. There was history of neck pain, occasional nausea /vomiting and no neck stiffness .He had no other remarkable past history of medical and surgical illness. Before presentation, he had been kept on various intravenous antibiotics in private hospitals, with no clinical improvement. Physical examination showed a young man in an altered level of consciousness with signs of meningeal irritation and had left spastic hemiparesis. The patient had progressive respiratory distress with rapid shallow breathing, while using all accessory muscles of respiration. He had a respiratory rate of 35 breaths min -1 , and a fluctuating arterial oxygen saturation of 70~80% with 10 L.min -1 of supplementary oxygen. The patient was ventilated with the synchronized intermittent mandatory ventilation with volume controlled mode selected. The ventilatory settings were as follows: FiO 2 0.40; respiratory rate 14 breaths/min; Tidal volume500ml; pressure support 12 cm H 2 O; positive end expiratory pressure (PEEP) 5 cm H 2 O.With above mentioned settings, the peak airway pressure (PIP) was 16 cm H 2 O, and the arterial blood gas parameters were satisfactory .A lumbar puncture was performed with 23 G spinal needle and produced opalescent cerebrospinal fluid (CSF) with CSF pressure of 14 cm of H20. The biochemical/microbiological features of CSF are :-Protein 80mg/dl; glucose 40mg/dl; WBC 75 /micro L, chiefly there was Lymphocyte (70%)and CSF acid fast and grams staining were negative . CSF culture was not sent .The computed tomography scan of brain showed obstructive hydrocephalus. These above mentioned feature was suggestive of tuberculous meningitis .He was placed immediate on antituberculous drugs and intravenous steroids and mannitol .He was successfully weaned off mechanical ventilatory support after 10 days. After first day of weaning patient experienced of headache and vertigo. Intensivist assumed that headache and vertigo is a part of TBM and symptoms will subside after few da...

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“…Entretanto, tais condutas têm sido contestadas por outros autores como THORNBERRY e TOMAS (8) , BELDO e COLS (I) e FLAATEN e COLS ( 3 ) . Tais autores acreditam que, tanto a pennanência no leito, como a deambulação precoce, não interferem na incidência da cefaléia.…”

Section: Introductionunclassified

Cefaléia pós-punção subaracnóidea: influência do calibre da agulha e da deambulação precoce

Ferreira¹,

Duarte²

1993

Rev. Bras. Enferm.

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RESUMO: Busca mos verificar a infl uência do calibre da agulha e da deambulação na ocorrência de cefaléia pós punção subaracnóidea. A amostra constou de 40 pacientes, divididos em 2 grupos de 20. Um grupo foi submetido a punção subaracnóidea com agulha 80x7 , e o outro com agulha 80x5 . Após a cirurgia os grupos foram redivididos em sub-grupos de 10 pacientes: um sub-grupo recebeu orientação para permanecer no leito por 24 horas pós ciru rgia, o outro para deambular após 4 horas. Os resultados demonstrara m 100% de ausência de cefaléia nos pacientes puncionados com agulha 80x5 . Nos pacientes puncionados com agulha 80x7 apresentaram cefaléia: 30% dos que deambularam entre 4 e 6 horas e 10% dos que permaneceram 24 horas no leito.ABSTRACT: With this research , we verified the influence of needle caliber on the incidence of headaches in patients after subrachonoid puncture. The sample consisted at 40 patients, divided into two groups of 20 patients. One group was tested with an 80x7 needle during subrachonoid puncture while the other group was tested with an 80x5 needle during the procedure. After the surgery each group was red ivided into subgroups of 10 patients; this one subgroup fro m each larger group was instructed to lie f1aton their backs for 24 hours after surgery. The other subgroup from each category was instructed to lie down fo r just 4 hours afie r surgery and to then get up and walk around. The results demonstrate a total absence of headaches after surgery in patients who were treated with an 80x5 needle. Of patientes treated with an 80x7 needle, 30% of the subgroup which got up afie r only 4 to 6 hours experienced headaches, while just 10% ofthe subgroup which termained laying down fo r 24 hours expeienced headaches. INTRODUÇÃObloqueio intenso, que é mais constante na sua distri buição. Por estas razões, a anestesia subaracnóidea é preferida para injeções únicas. o que despertou em nós o interesse na realização desta pesquisa fo i o fato de fa zermos parte da equipe de saúde de um Centro Cirúrgico já há vários anos, e constantemente participarmos de discussões quanto à etiologia da cefaléia pós punção subaracnóidea.A anestesia subaracnóidea, ou raquianestesia, é descrita por WILDSMITII ( 9 ) como mais fác il de aprender, de rápida execução, mais objetiva na iden tificação do posicionamento da agulha, sua ação tem início mais rápido, e, a difusão é mais controlável, quando comparado ao bloqueio periduraI. Além dis so, com menor dose de anestésico local, produz-se um Segundo THORNEBERR Y e TOMAS (8) , o grande inconveniente da punção subaracnóidea é a possibilidade da cefaléia pós-operatória, caracteriza da por aumentar de intensidade na posição ortostática, e ser aliviada com a posição supina. Ela é considerada grave, quando outros sinais e sinto mas como náuseas, vômitos, estrabismo, visão borrada, diplopia, zumbi dos ou vertigens, ocorrem concomitantemente.De acordo com LEE e A TKINSON ( 5 ) na punção subaracnóidea, a agulha atravessa a dura-mater, que consiste de uma camada fibrosa fo rte, fo rman...

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Postoperative headache in young patients after spinal anaesthesia

Abstract: Summary

Cited by 83 publications

References 10 publications

Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Cefaléia pós-punção subaracnóidea: influência do calibre da agulha e da deambulação precoce

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