Chua H, Loh L, Mok M
SingHealth Anaesthesiology Residency Program Singapore.
Division of Anaesthesiology and Perioperative Sciences Singapore General Hospital Singapore.
Anaesth Rep. 2021 Mar 1;9(1):37-40. doi: 10.1002/anr3.12101. eCollection 2021 Jan-Jun.
Lumbar epidurals are frequently inserted for women in labour as they provide excellent analgesia. One of the more common procedural complications is post-dural puncture headache which can be associated with auditory symptoms such as hearing loss and tinnitus and can be treated with an epidural blood patch. Sphenopalatine ganglion blocks have also been used to treat post-dural puncture headache but have not been previously shown to resolve the associated tinnitus. We report a case where postural neck pain and tinnitus from an accidental dural puncture during lumbar epidural insertion for labour analgesia was treated successfully with a sphenopalatine ganglion block. Further, we explore the literature on the cause of tinnitus in post-dural puncture headache and the possible mechanism by which a sphenopalatine ganglion block relieves both post-dural puncture headache and the associated tinnitus.
腰椎硬膜外麻醉常用于分娩期女性，因为它能提供良好的镇痛效果。较常见的操作并发症之一是硬膜穿刺后头痛，可能伴有听力损失和耳鸣等听觉症状，可通过硬膜外血贴治疗。蝶腭神经节阻滞也被用于治疗硬膜穿刺后头痛，但此前尚未证明其能缓解相关耳鸣。我们报告一例病例，在为分娩镇痛进行腰椎硬膜外穿刺时意外硬膜穿刺导致的姿势性颈部疼痛和耳鸣，通过蝶腭神经节阻滞成功治愈。此外，我们探讨了硬膜穿刺后头痛中耳鸣原因的文献，以及蝶腭神经节阻滞缓解硬膜穿刺后头痛及相关耳鸣的可能机制。
