Wet Tap, Worse Outcomes: Complications Following Post-Dural Puncture Headache.
Wet Tap, Worse Outcomes: Complications Following Post-Dural Puncture Headache. Anesth Analg. 2019 Nov;129(5):1192 Authors: Wanderer JP, Nathan N PMID: 31613805 [PubMed - in process]
The authors report on the autopsy case of a 40-year-old primigravida without either coagulation disorders or anticoagulant/antiplatelet therapy, who developed a fatal intracranial subdural hematoma after spinal anesthesia (SA) for elective cesarean delivery for tocophobia. Intracranial subdural hematoma is the most dreaded complication of SA and is often misdiagnosed with postdural puncture headache. In this article, the authors discuss pathophysiological mechanisms and risk factors for the development of an intracranial subdural hematoma after SA and review the pertinent literature.
Conclusions: Spinal anesthesia with a median or paramedian approach at cesarean section has no effect on the incidence of PDPH, but we believe that there has been a need for further studies with larger or different patient populations.
ConclusionsThe management of patients with NORSE remains challenging, often requiring multiple intravenous anaesthetic treatments, leading to complicated and prolonged hospital and intensive care unit stays but good outcome remains possible.
Conclusion: This study, found that ondansetron weight adjusted dose at 0.1mg/kg, reduced the severity of shivering when compared to a fixed dose ondansetron at 4mg.Keywords: Weight-adjusted dose,fixed dose ondansetron, shivering, spinal anaesthesia, caesarean deliveries.
Authors: Yilmaz G, Akca A, Kiyak H, Salihoglu Z Abstract BACKGROUND: Optic nerve sheath diameter (ONSD) measurement with ultrasound has emerged as a simple, non-invasive and reliable surrogate of invasive intracranial pressure (ICP) measurement. Increase in ICP might lead to postoperative nausea and vomiting (PONV) and postoperative headache. Here, we aimed to evaluate the extent of change in ONSD, resulting from pneumoperitoneum (PP) and Trendelenburg (TP) position during the laparoscopic hysterectomy (LH), by using ultrasonographic ONSD measurement. We also aimed to investigate the relation of ONSD with PONV and ...
ConclusionsWe showed a relatively low incidence (
A 17-year-old boy developed postdural puncture headache after several lumbar punctures (LPs) for intrathecal chemotherapy. The pediatric anesthesiology service was consulted for an epidural blood patch (EBP). Sedation was required for the LPs, which made performing an EBP problematic because of the need for the patient to be conscious and able to report symptoms during injection of blood. An epidural catheter was placed after the next LP while the patient was sedated. After he woke up, blood was injected through the catheter and the headache resolved. This technique can be used in pediatric patients requiring deep sedation for an EBP.
This study provides the first direct evidence that oxytocin, probably by OTR activation at TCC level inhibited dural nociceptive-evoked action potential in this complex. Thus, targeting OTR at TCC could represent a new avenue to treat migraine. PMID: 31678349 [PubMed - as supplied by publisher]
ConclusionThis study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail.ResumoJustificativa e objetivosA calcitonina é um hormônio polipeptídico que regula o metabolismo do cálcio no organismo. Por muitos anos a calcitonina tem sido usada para manter e melhorar a densidade mineral óssea e reduzir a incidência de fraturas. Muitos ...
CONCLUSIONS: In this review, the number of studies and participants for most of our analyses were small and some of the included trials had design limitations. There was some suggestion that, compared to spinal anaesthesia, CSE could be associated with a reduction in the number of women with intra-operative hypotension, but an increase in intra-operative nausea and vomiting requiring treatment. One small study found that low-dose spinal resulted in a faster time to effective anaesthesia compared to CSE. However, these results are based on limited data and the difference is unlikely to be clinically meaningful. Consequently...