Gisore E, Mung'ayi V, Sharif T
Department of Anaesthesia, Aga Khan University Hospital, Nairobi, P.O. Box 30270 - 00100, Nairobi, Kenya.
East Afr Med J. 2010 Jun;87(6):227-30. doi: 10.4314/eamj.v87i6.63078.
Post dural puncture headache can be a debilitating complication of subarachnoid anaesthesia for a new mother. Successful management of post dural puncture headache requires adherence to clear policies and protocols with close follow up of patients by an experienced obstetric anaesthetist.
To examine the cumulative incidence and severity of post dural puncture headache in obstetric patients who consented for spinal anaesthesia for Caesarean section.
Prospective cohort study.
All women who underwent Caesarean sections under spinal anaesthesia and fulfilled the inclusion criteria.
Aga Khan University Hospital, a teaching and referral hospital in Nairobi, Kenya.
The overall cumulative incidence of post dural puncture headache was found to be 20.35 % but was significantly higher in patients in whom the quincke type of needle was used than in those whose spinal anaesthetics were administered using the pencil point needle (24.2% and 4.5% respectively: p=0.042).
The incidence of post dural puncture headache can be significantly reduced in the obstetric population at the Aga Khan University Hospital if the pencil point spinal needle was to be routinely used. We recommend that the Quincke needles should not be used in the obstetric population at the Aga Khan University Hospital.
硬膜穿刺后头痛可能是新妈妈蛛网膜下腔麻醉的一种使人衰弱的并发症。成功处理硬膜穿刺后头痛需要遵循明确的政策和方案，并由经验丰富的产科麻醉医生对患者进行密切随访。
研究同意接受剖宫产脊髓麻醉的产科患者硬膜穿刺后头痛的累积发生率和严重程度。
前瞻性队列研究。
所有接受脊髓麻醉下剖宫产且符合纳入标准的女性。
肯尼亚内罗毕的教学及转诊医院阿迦汗大学医院。
发现硬膜穿刺后头痛的总体累积发生率为20.35%，但使用昆克式针的患者显著高于使用笔尖式针进行脊髓麻醉的患者（分别为24.2%和4.5%：p = 0.042）。
如果在阿迦汗大学医院产科常规使用笔尖式脊髓针，硬膜穿刺后头痛的发生率可显著降低。我们建议阿迦汗大学医院产科不应使用昆克针。
