Bellas S, Marenco M L, Sepúlveda A, Suan C
Servicio de Anestesiología y Reanimación del Hospital de la Mujer, Sevilla, España.
Rev Esp Anestesiol Reanim. 2012 Oct;59(8):410-4. doi: 10.1016/j.redar.2012.03.023. Epub 2012 May 19.
Accidental dura mater puncture is a potential complication during epidural block, and may be associated with multiple factors. Our objective was to determine the prevalence and risk factors of accidental dural puncture in a university hospital, evaluating the differences in the number of complications during different working hours.
A prospective observational study was conducted on all women who requested regional anaesthesia in the Epidural Analgesia Unit between 1 January 2009 and 1 January 2011, and who fulfilled the inclusion criteria. The technique employed to control labour pains was epidural analgesia.
A total of 12,480 pregnant women were included. The prevalence of accidental dura mater puncture was 0.4% (50 patients). Of these, 28% were due to medical residents. More accidental dura mater punctures were observed during September and in the afternoon shift.
The prevalence of accidental dura mater puncture is similar to other patient series. In ours, tiredness or lack of sleep did not influence the incidence of complications in analgesia for labour pains in a 24 hour care unit. This may be due to the distribution of on-call shifts not exceeding more than 6 hours.
硬膜外穿刺时意外穿破硬膜是一种潜在并发症，可能与多种因素相关。我们的目的是确定一所大学医院中意外穿破硬膜的发生率及危险因素，评估不同工作时间并发症数量的差异。
对2009年1月1日至2011年1月1日期间在硬膜外镇痛单元要求进行区域麻醉且符合纳入标准的所有女性进行前瞻性观察研究。控制分娩疼痛采用的技术是硬膜外镇痛。
共纳入12480名孕妇。意外穿破硬膜的发生率为0.4%（50例患者）。其中，28%是由住院医师操作导致。9月和下午班次期间观察到更多的意外穿破硬膜情况。
意外穿破硬膜的发生率与其他患者系列相似。在我们的研究中，疲劳或睡眠不足并未影响24小时护理单元中分娩疼痛镇痛并发症的发生率。这可能是由于值班班次时长不超过6小时。
