Nikolajsen L, Larsen K M, Kierkegaard O
Department of Anaesthesiology, Herning Hospital, Denmark.
Br J Anaesth. 1994 Mar;72(3):295-7. doi: 10.1093/bja/72.3.295.
We have examined the relationship between perioperative headache and various factors in 219 patients who fasted from midnight and underwent minor surgery under general anaesthesia. Four to six hours after operation all patients completed a questionnaire on previous frequency of headache, daily consumption of caffeine and occurrence of perioperative headache. The duration of fasting, type of surgery, premedication and anaesthetic agents used were obtained from the anaesthetic record. After multivariate logistic regression analysis a significant risk of preoperative headache was found in patients who normally experienced headache more than twice a month (odds ratio (OR): 7.7; confidence interval (CI): 2.9-20.1), had a daily caffeine consumption > 400 mg/24 h (OR: 5.0; CI: 1.6-14.8) and who were anaesthetized after 12:00 (OR: 3.7; CI: 1.4-9.8). The risk of postoperative headache was significantly greater in patients with preoperative headache (OR: 16.9; CI: 6.5-43.8), daily caffeine consumption > 400 mg/24 h (OR: 3.9; CI: 1.5-9.6) and in those patients who received atracurium, which was similar to the risk of tracheal intubation.
我们研究了219例从午夜开始禁食并接受全身麻醉下小手术的患者围手术期头痛与各种因素之间的关系。术后4至6小时，所有患者完成了一份关于既往头痛频率、每日咖啡因摄入量和围手术期头痛发生情况的问卷。禁食时间、手术类型、术前用药和所用麻醉剂均从麻醉记录中获取。多因素逻辑回归分析后发现，每月通常头痛超过两次的患者发生术前头痛的风险显著增加（优势比（OR）：7.7；置信区间（CI）：2.9 - 20.1），每日咖啡因摄入量>400 mg/24小时的患者（OR：5.0；CI：1.6 - 14.8），以及12:00之后接受麻醉的患者（OR：3.7；CI：1.4 - 9.8）。术前有头痛的患者发生术后头痛的风险显著更高（OR：16.9；CI：6.5 - 43.8），每日咖啡因摄入量>400 mg/24小时的患者（OR：3.9；CI：1.5 - 9.6），以及接受阿曲库铵的患者，其风险与气管插管的风险相似。
