From the Icahn School of Medicine at Mount Sinai, New York, New York.
Anesth Analg. 2017 Apr;124(4):1219-1228. doi: 10.1213/ANE.0000000000001840.
Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections. Last, the evidence behind interventional pain modalities and acupuncture will be examined.
分娩产妇常采用椎管内神经阻滞麻醉,而硬脊膜穿破后头痛是该技术最常见的并发症。虽然硬膜外血贴是治疗该并发症的首选方法,但有些患者拒绝或禁忌该治疗。本文的目的是回顾研究最多的替代方法治疗硬脊膜穿破后头痛的疗效。这将包括讨论各种口服或静脉内治疗以及不含血液的硬膜外注射。最后,还将检查介入性疼痛治疗和针灸的证据。