Department of Anesthesiology, Stony Brook Medical Center, Stony Brook, NY, USA.
Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, 11794-8480, USA.
Can J Anaesth. 2019 Dec;66(12):1464-1471. doi: 10.1007/s12630-019-01486-6. Epub 2019 Sep 17.
Accidental dural puncture and post-dural puncture headache are well-known complications of neuraxial anesthesia in parturients. The primary goal of this study was to identify the rate of post-dural puncture headache and epidural blood patch in all parturients who received a neuraxial anesthetic during a ten-year period at an academic tertiary-care medical centre. A secondary goal was to identify any delay in hospital discharge due to a post-dural puncture headache.
We conducted a retrospective analysis of all patients who received a neuraxial anesthetic on the labour and delivery unit at Stony Brook Medical Center from 1 January, 2006 to 31 December, 2015. Standardized neuraxial anesthesia equipment was used throughout this period. Chart reviews were conducted on all patients who received a neuraxial anesthetic and had an accidental dural puncture and/or developed a post-dural puncture headache.
Of the 32,655 neuraxial anesthetics performed, 298 (0.9%) patients experienced a post- dural puncture headache. Analysis of all patients who developed a post-dural puncture headache showed that 150 (50.3%) patients received one or more epidural blood patches. Overall, 19 (0.06%) patients had a delay in hospital discharge due to a post-dural puncture headache.
We showed a relatively low incidence (< 1%) of post-dural puncture headache following neuraxial anesthesia in parturients at an academic tertiary-care medical centre. Patients that rated their post-dural puncture headache as very severe were more likely to undergo at least one epidural blood patch procedure. Post-dural puncture headache is a well-known complication of neuraxial anesthesia, and may lead to a delay in hospital discharge.
在产妇的椎管内麻醉中，意外的硬脊膜穿刺和穿刺后头痛是众所周知的并发症。本研究的主要目的是确定在一家学术性三级保健医疗中心的十年期间，所有接受椎管内麻醉的产妇中穿刺后头痛和硬膜外血补丁的发生率。次要目标是确定由于穿刺后头痛而导致的任何住院延迟。
我们对 2006 年 1 月 1 日至 2015 年 12 月 31 日期间在 Stony Brook Medical Center 分娩和分娩单位接受椎管内麻醉的所有患者进行了回顾性分析。在此期间，使用了标准化的椎管内麻醉设备。对所有接受椎管内麻醉且发生意外硬脊膜穿刺和/或发生穿刺后头痛的患者进行了病历回顾。
在 32655 次椎管内麻醉中，298 例（0.9%）患者出现穿刺后头痛。对所有发生穿刺后头痛的患者进行分析，发现 150 例（50.3%）患者接受了一次或多次硬膜外血补丁治疗。总体而言，有 19 例（0.06%）患者由于穿刺后头痛而导致住院延迟。
我们在学术性三级保健医疗中心的产妇中，显示了相对较低的（<1%）椎管内麻醉后穿刺后头痛发生率。将穿刺后头痛评为非常严重的患者更有可能进行至少一次硬膜外血补丁治疗。穿刺后头痛是椎管内麻醉的一个已知并发症，可能导致住院延迟。
