Gill P S, Guest C, Rabey P G, Buggy D J
Leicester General Hospital, University Department of Anaesthesia, Leicester, UK.
Eur J Anaesthesiol. 2003 May;20(5):401-3. doi: 10.1017/s0265021503000619.
Headache is a common and distressing morbidity associated with day case surgery. We undertook a prospective, observational study to identify risk factors associated with perioperative headache in a modern, day case surgery setting.
Two hundred-and-thirty consecutive patients presenting for day case surgery were invited to complete a questionnaire about their previous experience of headache and various associated risk factors. Questionnaires were completed by 90% of patients. The presence of headache in the pre- or postoperative period was also documented. We used multivariate logistic regression to model perioperative headache.
Increased frequency of previous headache, odds ratio (95% confidence interval) 1.9 (1.2-2.8) (P = 0.004) and low alcohol consumption 0.90 (0.87-0.98) (P = 0.019) were significant predictors. A history of migraine showed a trend towards being predictive 1.9 (0.9-4.0) (P = 0.055). Some risk factors thought to be important such as caffeine withdrawal and duration of starvation and fluid deprivation were not associated with perioperative headache in this setting.
In this study of risk factors associated with perioperative headache in day case surgery, increased frequency of headache and low alcohol consumption were independent risk factors.
头痛是日间手术常见且令人困扰的一种病症。我们开展了一项前瞻性观察性研究，以确定在现代日间手术环境中与围手术期头痛相关的风险因素。
邀请连续230例接受日间手术的患者填写一份关于他们既往头痛经历及各种相关风险因素的问卷。90%的患者完成了问卷。还记录了术前或术后头痛的发生情况。我们使用多因素逻辑回归对围手术期头痛进行建模。
既往头痛频率增加，比值比（95%置信区间）为1.9（1.2 - 2.8）（P = 0.004）以及低酒精摄入量0.90（0.87 - 0.98）（P = 0.019）是显著的预测因素。偏头痛病史显示出有预测趋势，比值比为1.9（0.9 - 4.0）（P = 0.055）。一些被认为重要的风险因素，如咖啡因戒断、禁食和禁水时间，在这种情况下与围手术期头痛无关。
在这项关于日间手术围手术期头痛相关风险因素的研究中，头痛频率增加和低酒精摄入量是独立的风险因素。
