Sinikoglu Nadir S, Yeter Hacer, Gumus Funda, Belli Enver, Alagol Aysin, Turan Nesrin
Department of Anaesthesiology and Intensive Care, Bagcilar Egitim ve Arastirma Hospital, Istanbul, Turkey.
Braz J Anesthesiol. 2013 Mar-Apr;63(2):188-92. doi: 10.1016/S0034-7094(13)70213-7.
This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH).
We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study.
Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH.
In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.
本研究旨在探讨脊髓麻醉术后重新插入导丝对硬膜穿刺后头痛（PDPH）的影响。
我们招募了630例接受脊髓麻醉择期手术的患者，并将他们随机分为A组（拔针前更换导丝）和B组（不拔导丝直接拔针）。这些患者在医院观察24小时，并在研究的第3天和第7天检查是否发生PDPH。
总体而言，PDPH发生率为10.8%（68例患者）。其中A组（拔针前更换导丝）的33例患者（10.5%）和B组（不拔导丝直接拔针）的35例患者（11.1%）发生了PDPH。两组之间PDPH发生率无显著差异。
与诊断性腰椎穿刺不同，使用25号Quincke针进行脊髓麻醉后重新插入导丝并不能降低PDPH的发生率。
