Kshatri A M, Foster P A
Department of Anesthesia, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA.
Reg Anesth. 1997 Sep-Oct;22(5):432-4. doi: 10.1016/s1098-7339(97)80029-6.
In two patients, one scheduled for epidural anesthesia and the other for placement of a spinal catheter for operative procedures, severe postdural puncture headache developed and was refractory to conservative therapy.
The first patient had several unintentional dural punctures, and the second underwent a planned dural puncture with an 18-gauge needle for insertion of a 20-gauge catheter. When neither patient responded to conservative therapy following development of postdural puncture headache, an infusion of adrenocorticotropic hormone (ACTH) was given prior to consideration of epidural blood patching.
Both patients obtained complete and permanent relief from their headaches.
A single treatment with ACTH may offer an alternative therapy in the treatment of postdural puncture headache.
在两名患者中，一名计划接受硬膜外麻醉，另一名计划在手术过程中放置脊髓导管，均发生了严重的硬膜穿刺后头痛，且对保守治疗无效。
第一名患者发生了多次意外硬膜穿刺，第二名患者计划用18号针进行硬膜穿刺以插入20号导管。两名患者在发生硬膜穿刺后头痛后对保守治疗均无反应，在考虑硬膜外血贴之前给予促肾上腺皮质激素（ACTH）输注。
两名患者的头痛均得到完全且持久的缓解。
单次使用ACTH治疗可能为硬膜穿刺后头痛的治疗提供一种替代疗法。
