Poukkula E
Ann Chir Gynaecol. 1984;73(3):139-42.
Headache is the most common complication of spinal anaesthesia. Although it is usually harmless it can, however, be so distressing to the patient that the fear of this unpredictable drawback may make many anaesthetists reluctant to use this simple anaesthetic technique. Although it is difficult to predict which patients will get post-spinal headache (PSH), we fortunately know some groups of patients who are more susceptible to PSH than others. They include young patients, female patients, patients with a history of travel sickness, patients with previous PSH, patients with an asthenic constitution and patients who have a minor operation with prompt discharge. The use of a thin needle (25-26 G) reduces the occurrence of PSH. Hydration during the operation day does not prevent PSH, nor does recumbency of 24 hours. The results are contradictory when a prophylactic epidural blood patch is used to prevent PSH. Although PSH usually ceases spontaneously within 1-4 days, treatment with an epidural blood patch is indicated if PSH is severe or affects the time of discharge. The presence of this complication must be recognised, should be avoided as far as possible and treated when necessary, but it certainly does not prevent the use of spinal anaesthesia.
头痛是脊髓麻醉最常见的并发症。尽管它通常无害，但对患者来说可能非常痛苦，以至于对这种不可预测的缺点的恐惧可能会使许多麻醉师不愿使用这种简单的麻醉技术。虽然很难预测哪些患者会发生脊麻后头痛（PSH），但幸运的是，我们知道一些比其他患者更容易发生PSH的人群。他们包括年轻患者、女性患者、有晕动病史的患者、既往有PSH的患者、体质虚弱的患者以及接受小手术且很快出院的患者。使用细针（25 - 26G）可减少PSH的发生。手术当天补液不能预防PSH，24小时卧床也不能预防。使用预防性硬膜外血贴预防PSH的结果存在矛盾。虽然PSH通常会在1 - 4天内自行缓解，但如果PSH严重或影响出院时间，则需进行硬膜外血贴治疗。必须认识到这种并发症的存在，应尽可能避免，并在必要时进行治疗，但它肯定不会妨碍脊髓麻醉的使用。
