Akyol Fethi, Binici Orhan, Çakır Mahmut
Department of Anaesthesiology and Reanimation, Erzincan State Hospital, Erzincan, Turkey.
Turk J Anaesthesiol Reanim. 2014 Feb;42(1):40-2. doi: 10.5152/TJAR.2013.59. Epub 2013 Aug 29.
Treatment of postdural puncture headaches involves oral or intravenous (IV) fluid or caffeine-containing analgesics, micro-catheterization of spinal space, epidural administration of blood obtained from the patient, or epidural blood patch and fiberoptic imaging-guided epidural interventional techniques. Epidural blood patch is, to date, the most effective treatment, but it is an invasive procedure that may result in serious complications. Spinal anaesthesia was planned for a 22 year old male patient diagnosed with inguinal hernia and for a 42 year old female patient diagnosed with venous stasis. On the first post-operative day, the patients with a postdural puncture headache received conservative medical treatment. As medical treatment was ineffective, they received ultrasound-guided greater bilateral occipital nerve block. In this case report, the effect of the ultrasound-guided bilateral greater occipital nerve block on postdural puncture headache is discussed.
硬膜穿刺后头痛的治疗方法包括口服或静脉输注液体、含咖啡因的镇痛药、脊髓腔微导管插入术、硬膜外注射患者自身血液、硬膜外血贴以及纤维光学成像引导下的硬膜外介入技术。迄今为止,硬膜外血贴是最有效的治疗方法,但它是一种侵入性操作,可能会导致严重并发症。计划对一名诊断为腹股沟疝的22岁男性患者和一名诊断为静脉淤滞的42岁女性患者实施脊髓麻醉。术后第一天,发生硬膜穿刺后头痛的患者接受了保守药物治疗。由于药物治疗无效,他们接受了超声引导下双侧枕大神经阻滞。在本病例报告中,讨论了超声引导下双侧枕大神经阻滞对硬膜穿刺后头痛的疗效。