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对在脊髓麻醉下进行手术的患者视觉神经外直径的大小的影响与外围神经阻塞 - 一项随机对照研究
Sangineni Kalyani Surya Dhana Lakshmi1, A Bhargav Ram1, Ch Rama Krishna Prasad1
1Department of Anaesthesiology, AIIMS, Bibinagar, Telangana, India.
Indian journal of anaesthesia
|March 31, 2025
概括
持续性刺伤后头痛 (PDPH) 与脊髓麻醉有关. 这项研究发现,视神经外直径 (ONSD) 在脊髓麻醉后显著下降,这表明内压力降低,并可能预测PDPH.
科学领域:
- 麻醉学 麻醉学
- 神经学 神经学
- 医疗成像医学成像
背景情况:
- 持续性刺伤后头痛 (PDPH) 是脊髓麻醉后的一个已知的并发症.
- 理论上PDPH的原因是由于脑脊液泄漏而导致的内压力下降.
- 视神经外直径 (ONSD) 是内压力的潜在指标.
研究的目的:
- 调查脊柱麻醉是否导致ONSD的降低,反映了内压力降低.
- 评估ONSD变化作为脊柱后麻醉并发症的潜在生物标志物.
主要方法:
- 随机对照试验比较脊髓麻醉 (S组) 与外围神经阻塞 (P组).
- 在手术前,手术后4小时和24小时,在仰卧和坐着的姿势下进行了ONSD测量.
- 统计分析包括连续变量的t测试和重复测量ANOVA与邦费罗尼校正.
主要成果:
- 与基线相比,在脊髓麻醉后4小时和24小时观察到平均ONSD的统计学显著下降.
- 在外围神经阻塞组中没有发现ONSD的显著变化.
- 患者在24小时或5天随访后没有报告头痛.
结论:
- 测量ONSD是一种简单且具有成本效益的方法,用于检测脊髓后麻醉后内压力下降的情况.
- 在脊髓麻醉后,ONSD变化可能成为监测患者的有用,非侵入性工具.
- 需要进行进一步的研究,以确定用于预测PDPH风险的ONSD截止值.
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