Regional Versus General Anesthesia in the Elderly: New Insights

Lin, Jonathan Dun-Chi; Ouanes, Jean-Pierre P.; Sieber, Frederick E.

doi:10.1007/s40140-017-0236-3

Cited by 1 publication

(1 citation statement)

References 36 publications

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“…Despite new methods and techniques to manage the pain, the PDPH remains a major complication [ 5 ], and the significance of the pain management is critical owing to the increased use of spinal anesthesia as general anesthesia [ 6 , 7 ]. The incidence of PDPH is affected by many factors such as age, sex, cerebrospinal fluid (CSF) volume, local anesthetic agents; as well as some conditions such as pregnancy [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Prone position: A possible method to decrease post dural puncture headache (PDPH) during surgery

Alizadeh

Aghsaeifard

Fereydoonnia

et al. 2022

Annals of Medicine &Amp; Surgery

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Objectives Postdural puncture headache (PDPH) is a complication associated with spinal and epidural anesthesia, characterized by a very severe dull, non-throbbing positional headache along with nausea, vomiting and other symptoms. The aim of this study was to compare positional character of PDPH, where the effects of prone and supine positions during surgery were compared for the risk of the headache. Methods This cohort study, was carried out at (XXX) University of Medical Sciences from June 2019 to June 2020 after the approval from the Ethical Committee. 1416 patients participated in this study among whom either supine or prone positions were used for the surgery, based on the type of surgical requirements. All patients received spinal where, 18-gauge cannula was inserted and lactated ringer 4 mL per Kg per hour was used for the administration. Using an aseptic technique, a 26-gauge Quincke needle was inserted intrathecally via a midline approach into the L3-L4 or L4-L5 interspace with the patient in the sitting position. Patients received 10 mg 0.5% hyperbaric bupivacaine. 444 patients were operated in the prone position during surgery (P group) and the 972 patients were in the supine position (S group). Results We compared the rate of PDPH between the two groups. 3 (0.68%) patients with pilonidal sinus were operated in prone position experienced headache and 87 of those operated in supine position (8.95%) had headache (P < 0.001); and the odds ratio of developing headache when operated in supine position was 13.16. Conclusions Prone position during surgery appears to be a reliable way to reduce PDPH following spinal or epidural anesthesia.

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