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2019年印度农村地区医学院的经验:一项前瞻性队列研究设计,探讨使用26G Quincke脊髓穿刺针在脊髓麻醉下进行剖宫产的女性中“硬膜穿刺后头痛”的发生率及危险因素。

Incidence and Risk Factors of "Postdural Puncture Headache" in Women Undergoing Cesarean Delivery under Spinal Anesthesia with 26G Quincke Spinal Needle, Experience of Medical College in Rural Settings in India 2019: A Prospective Cohort Study Design.

作者信息

Thakur Sunil, Sharma Anupriya, Kaushal Sushruti, Sharma Ashish, Sharma Nisha, Thakur Preyander Singh

机构信息

Department of Anesthesia, Dr. Radhakrishnan Government Medical College, Hamirpur, Himachal Pradesh, India.

Department of Dentistry, Dr. Radhakrishnan Government Medical College, Hamirpur, Himachal Pradesh, India.

出版信息

J Pharm Bioallied Sci. 2022 Jul;14(Suppl 1):S209-S213. doi: 10.4103/jpbs.jpbs_72_22. Epub 2022 Jul 13.

Abstract

INTRODUCTION

Almost every cesarean delivery is done under spinal anesthesia because of ease of doing, rapid onset, avoids maternal and fetal risk of general anesthesia, promotes early recovery. Major complication especially in young women undergoing LSCS under spinal anesthesia is post dural puncture headache (PDPH) which is caused by cerebrospinal fluid leakage. There is wide variation in reported incidence of PDPH (0.3% to 40 %) after spinal anesthesia being affected by various procedure and non procedure related risk factors like age, gender, needle size and type, numbers of spinal attempts and previous history of PDPH.

METHODS

Prospective cohort study was conducted in 335 patients posted for caesarean section under spinal anesthesia from January 2019 to September 2019 in medical College situated in rural India. Spinal anesthesia was given by 26 G Quincke spinal needle. All patients were evaluated for incidence and severity of PDPH from post operative day 1 to day 5.

RESULT

Incidence of PDPH was 11.4% in this study. Majority of patients (62.5%) were having mild pain. All patients reported PDPH with 72 hours.

CONCLUSION

Body mass index (BMI), h/o PDPH, multiple attempts for successful spinal anesthesia did not have any significant association with PDPH in our study.

摘要

引言

几乎每例剖宫产手术都在脊髓麻醉下进行,因为操作简便、起效迅速,可避免全身麻醉对母体和胎儿的风险,还能促进早期恢复。脊髓麻醉下进行低位剖宫产手术时,尤其是年轻女性,主要并发症是硬膜穿刺后头痛(PDPH),这是由脑脊液漏引起的。脊髓麻醉后PDPH的报告发病率差异很大(0.3%至40%),受多种手术和非手术相关风险因素影响,如年龄、性别、针的尺寸和类型、脊髓穿刺尝试次数以及既往PDPH病史。

方法

2019年1月至2019年9月,在印度农村一所医学院对335例计划在脊髓麻醉下进行剖宫产手术的患者进行了前瞻性队列研究。使用26G Quincke脊髓穿刺针进行脊髓麻醉。对所有患者从术后第1天到第5天评估PDPH的发病率和严重程度。

结果

本研究中PDPH发病率为11.4%。大多数患者(62.5%)疼痛轻微。所有患者均在72小时内报告发生PDPH。

结论

在我们的研究中,体重指数(BMI)、PDPH病史、多次尝试成功进行脊髓麻醉与PDPH均无显著关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb08/9469433/f3f58e2858d7/JPBS-14-209-g001.jpg

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