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用于治疗腰椎引流引起的硬膜穿刺后头痛(PDPH)的硬膜外血贴(EBP)是否需要采用不同的方法?

Does an Epidural Blood Patch (EBP) for Postdural Puncture Headache (PDPH) From a Lumbar Spinal Drain Necessitate a Distinct Approach?

作者信息

Nimma Sindhuja, Maurer Adrian, Kampouri Dimitrios, Wardhan Richa

机构信息

Anesthesiology, Mayo Clinic, Jacksonville, USA.

Anesthesiology, University of Florida College of Medicine, Gainesville, USA.

出版信息

Cureus. 2023 Feb 17;15(2):e35098. doi: 10.7759/cureus.35098. eCollection 2023 Feb.

Abstract

An intentional or unintentional dural puncture puts patients at significant risk for a postdural puncture headache (PDPH). When conservative treatments fail, an epidural blood patch (EBP) is offered cautiously due to rare but devastating complications. The literature is abundant with reviews on the management of PDPH in obstetric patients, but there is a paucity of data on the management of PDPH and complications of EBP in patients post spinal drain placement. In this case report, we address the specific concerns that vascular patients may have about the outcomes of large needle sizes and suggest alternative approaches for non-obstetric patients.

摘要

硬膜穿刺无论是有意还是无意,都会使患者面临发生硬膜穿刺后头痛(PDPH)的重大风险。当保守治疗失败时,由于存在罕见但严重的并发症,硬膜外血贴(EBP)的应用需谨慎。关于产科患者PDPH管理的综述文献很多,但关于脊髓引流管置入术后患者PDPH管理及EBP并发症的数据却很少。在本病例报告中,我们探讨了血管疾病患者可能对大尺寸穿刺针的结果存在的具体担忧,并为非产科患者提出了替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cd6/10024888/a591ae33c303/cureus-0015-00000035098-i01.jpg

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