Post-dural puncture headache in the parturient

Abstract: Post-dural puncture headache (PDPH) is one of the most common and debilitating complications of neuraxial blockade in the parturient. The obstetric population is at particular risk with up to 80% of women developing symptoms after inadvertent dural puncture during epidural insertion. PDPH typically develops 24–48 hours post-puncture and is classically described as an occipito-frontal headache with postural features. Diagnosis and assessment should include consideration of other potential causes of post-partum headache. At the time of inadvertent dural puncture (IDP) one may insert an intrathecal catheter, re-site the epidural or use alternative analgesia. Initial treatment of a PDPH includes bed rest, adequate hydration and simple analgesics. Epidural blood patch (EBP) remains the gold standard treatment of PDPH.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: CORE: Obstetrics anaesthesia Source Type: research

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Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
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.
Source: The American Journal of Forensic Medicine and Pathology - Category: Forensic Medicine Tags: Original Articles Source Type: research
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.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
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.
Source: Seizure - Category: Neurology Source Type: research
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.
Source: African Health Sciences - Category: African Health Source Type: research
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 ...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
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Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
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.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
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]
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
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 ...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
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