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[分娩期间的产科硬膜外镇痛:一次硬膜穿刺,反复出现体位性头痛,三次血液填充疗法…]

[Obstetrical epidural analgesia during labour: one dural puncture, repeated postural headaches, three blood patches…].

作者信息

Villevieille T, Pasquier P, Muller V, Rousseau J-M, Le Marec C, Benhamou D

机构信息

Fédération d'anesthésie-réanimation, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94163 Saint-Mandé cedex, France.

出版信息

Ann Fr Anesth Reanim. 2010 Nov;29(11):803-6. doi: 10.1016/j.annfar.2010.09.003. Epub 2010 Oct 29.

Abstract

We report the case of a patient in whom three blood patches had to be performed to treat a post-dural puncture headache following the insertion of an epidural catheter for labour analgesia. There are few data about repeated blood patches used to treat recurring symptoms after failure of a previous blood patch. The technical guidelines used to perform a first blood patch should be followed for the next procedure as well. The role of the cerebrospinal fluid leaking in the symptoms has to be verified, to avoid performing a useless blood patch and to miss another cause, which needs an urgent treatment.

摘要

我们报告了一例患者的病例,该患者在插入硬膜外导管进行分娩镇痛后发生了硬膜穿刺后头痛,不得不进行三次血补丁治疗。关于在先前血补丁治疗失败后用于治疗复发症状的重复血补丁的数据很少。下次操作也应遵循用于进行首次血补丁的技术指南。必须核实脑脊液漏在症状中的作用,以避免进行无用的血补丁治疗并遗漏需要紧急治疗的其他病因。

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