Postpunktionskopfschmerz in der Geburtshilfe

Siegler, Benedikt Hermann; Oehler, Beatrice; Kranke, Peter; Weigand, Markus

doi:10.1007/s00101-022-01171-2

Cited by 4 publications

(7 citation statements)

References 80 publications

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“…Table 1. Definition, clinical characteristics and associated symptoms of postdural puncture headache (modified from [2]) to physically reduce CSF-leakage and to enhance local tissue reactions, resulting in a faster repair of the dural perforation [11]. Recently, Binyamin et al [12] investigated 550 cases of ADP upon labor EDA that was either followed by resited epidural or intrathecal catheter placement.…”

Section: Key Pointsmentioning

confidence: 99%

“…However, it is associated with several risks including another ADP, which has been estimated to occur in 0.5–1% of cases [ 24 ]. Absence of pain relief, symptom worsening or even focal neurological deficits should prompt to investigate possible differential diagnoses [ 2 ]. Reports of symptom recurrence due to subdural hygromas or pseudomeningoceles from previous dural punctures underline the importance of a multidisciplinary approach in PDPH treatment in case of a failed EBP, as this might avoid multiple punctures [ 25 , 26 ].…”

Section: Therapeutic Managementmentioning

confidence: 99%

“…Although classical symptoms might be absent, associated signs include neck stiffness, auditory and visual symptoms, dizziness and nausea (Table 1 ). While reduced cerebrospinal fluid (CSF) pressure and volume together with compensatory intracranial vasodilation are thought to be responsible, the exact mechanisms causing PDPH remain unknown [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacological treatment and therapeutic local anesthetics used at the authors' institutions (modified from[2])…”

mentioning

confidence: 99%

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Efficacy of therapies for post dural puncture headache

Thon,

Weigand,

Kranke

et al. 2024

Current Opinion in Anaesthesiology

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Purpose of review Clinical management of postdural puncture headache (PDPH) remains an interdisciplinary challenge with significant impact on both morbidity and quality of life. This review aims to give an overview of the most recent literature on prophylactic and therapeutic measures and to discuss novel findings with regard to currently published consensus practice guideline recommendations. Recent findings Although current evidence does not support a recommendation of any specific prophylactic measure, new data is available on the use of intrathecal catheters to prevent PDPH and/or to avoid invasive procedures. In case of disabling or refractory symptoms despite conservative treatments, the epidural blood patch (EBP) remains the therapeutic gold standard and its use should not be delayed in the absence of contraindications. However, recent clinical studies and meta-analyses provide additional findings on the therapeutic use of local anesthetics as potential noninvasive alternatives for early symptom control. Summary There is continuing research focusing on both prophylactic and therapeutic measures offering promising data on potential alternatives to invasive procedures, although there is currently no treatment option that comes close to the effectiveness of an EBP. A better understanding of PDPH pathophysiology is not only necessary to identify new therapeutic targets, but also to recognize patients who benefit most from current treatments, as this might enhance their therapeutic efficacy.

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Section: Key Pointsmentioning

confidence: 99%

Section: Therapeutic Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Pharmacological treatment and therapeutic local anesthetics used at the authors' institutions (modified from[2])…”

mentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of therapies for post dural puncture headache

Thon,

Weigand,

Kranke

et al. 2024

Current Opinion in Anaesthesiology

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“…Apesar de sua eficácia, o blood patch epidural pode ter complicações, como dor nas costas, febre e, em raros casos, infecção (Oumer et al, 2023). Portanto, é crucial avaliar os riscos e benefícios para cada paciente individualmente e monitorar cuidadosamente após o procedimento (Siegler et al, 2022).…”

Section: Blood Patch Epiduralunclassified

Cefaleia Pós-Punção Dural Em Raquianestesia: Uma Revisão Bibliográfica Sobre Incidência, Fatores De Risco E Estratégias De Manejo

De Carvalho Figueredo,

Inácio Aragão,

Alves de Oliveira

et al. 2024

RECIMA21

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A cefaleia pós-punção dural (CPPD) é uma complicação comum e debilitante após a raquianestesia, impactando negativamente a recuperação dos pacientes e aumentando os custos de saúde. Objetivo: Esta revisão bibliográfica tem como objetivo abordar sobre a incidência, fatores de risco e estratégias de manejo da CPPD em pacientes submetidos à raquianestesia. Métodos: Esta revisão bibliográfica foi conduzida por meio de uma busca sistemática na literatura científica publicada nos últimos 15 anos, abrangendo o período de 2009 a 2024, nas bases de dados PubMed, Web of Science, Scopus e Google Scholar. Os critérios de inclusão foram estudos originais e revisões em inglês, português ou espanhol, que investigaram estratégias de intervenção para CPPD. Excluíram-se relatos de caso, editoriais e estudos focados em outras condições médicas. Resultados e Discussão: A incidência da CPPD varia de 0,1% a 36%, sendo influenciada pela técnica anestésica e características do paciente. Fatores de risco incluem idade, sexo feminino e gravidez. A escolha de agulhas de menor calibre e com ponta de lápis reduz a incidência de CPPD. Técnicas de punção orientadas por ultrassonografia minimizam punções traumáticas. O manejo conservador, incluindo hidratação e uso de analgésicos é eficaz em casos leves. O blood patch epidural é o tratamento padrão-ouro para casos graves, enquanto derivados de cafeína são uma alternativa promissora. Conclusão: Esta revisão destaca a importância de uma abordagem multifacetada na prevenção e manejo da CPPD, integrando práticas baseadas em evidências, educação contínua dos profissionais de saúde e pesquisa contínua.

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Periduralanästhesie

Pöpping

Wenk²

2022

Anaesthesiologie

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Postpunktionskopfschmerz in der Geburtshilfe

Cited by 4 publications

References 80 publications

Efficacy of therapies for post dural puncture headache

Efficacy of therapies for post dural puncture headache

Cefaleia Pós-Punção Dural Em Raquianestesia: Uma Revisão Bibliográfica Sobre Incidência, Fatores De Risco E Estratégias De Manejo

Periduralanästhesie

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