风险因素的复发后腹腔穿刺头痛后一个外周血补丁:一个回顾性队列研究
S Tomala1, G L Savoldelli1, I Pichon1
1Division of Anaesthesia, Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
疼痛后刺痛头痛 (PDPH) 治疗用外周血贴 (EBP) 可能会失败. 更深的外周腔空间和更短的EBP间隔增加了失败风险,而更长的间隔改善了PDPH患者的成功.
科学领域:
- 产科 产科 产科 产科 产科
- 麻醉学 麻醉学
- 神经外科 神经外科
背景情况:
- 产后穿孔头痛 (PDPH) 影响了0.38-6.3%的产科神经轴手术.
- 外周血贴 (EBP) 是PDPH的标准,但在4-29%的病例中失败.
- 对EBP失败的风险因素尚未得到充分确定.
研究的目的:
- 为了确定与腹腔周围血补丁 (EBP) 失败相关的风险因素,在腹腔周围刺痛后头痛 (PDPH) 患者中.
主要方法:
- 对47920名接受神经轴手术的患者进行了回顾性队列研究 (2001-2018).
- 定义EBP失败是缺乏完全缓解症状或需要进一步治疗.
- 单变量和多变量分析比较了成功与失败的EBP组.
主要成果:
- 212名患者需要EBP;55人 (25.9%) 经历EBP失败.
- 增加了EBP失败的风险,外周腔深>5.5厘米 (或3.08).
- 减少EBP失败的风险,在持续穿刺和EBP (OR 0.20) 之间的时间间隔>48小时.
结论:
- 在EBP后PDPH的持续性是常见的.
- 脊外腔空间>5.5厘米深度或EBP<48小时后的患者面临更高的失败风险.
- 这些因素需要密切关注,以优化PDPH管理.
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