Actualización en cefalea post punción dural: ¿El hacer y no hacer?
Update in Post-Dural Puncture Headache: the do's and don'ts?
Marcel Vercauteren
Timisoara 2011;183
Post-Dural Puncture Headache (PDPH) is a well-known complication of intended dural puncture (anesthesia, diagnostic), catheterization (anesthesia, neurosurgery, pain therapy, oncology) or inadvertent dural puncture (epidural anesthesia, surgical). While anesthesiologists have anticipated this problem by using needles of smaller size and special design and radiologists have abandoned myelography, neurologists still have continued to use large bore Quincke needles.
http://www.atitimisoara.ro/_files/documents/files/2011/Recomandari-ATI-med-urgenta/Update%20in%20Post-Dural%20Puncture%20Headache.pdf
Cefalea post punción lumbar: diagnóstico y tratamiento
Post lumbar puncture headache: diagnosis and management.
Ahmed SV, Jayawarna C, Jude E.
Tameside General Hospital, Fountain Street, Ashton Under-Lyne OL6 9RW, UK. syed.ahmed@tgh.nhs.uk
Postgrad Med J. 2006 Nov;82(973):713-6.
Abstract
Lumbar puncture is a frequently performed procedure in medical emergencies and anaesthesia. Headache after lumbar puncture is a common occurrence (32%) and carries a considerable morbidity, with symptoms lasting for several days, at times severe enough to immobilize the patient. If untreated, it can result in serious complications such as subdural haematoma and seizures, which could be fatal. Certain factors contribute to the development of headache after lumbar puncture. If these factors are taken into consideration, the incidence of headache could be markedly reduced. It is therefore important that the doctors are aware of the methods available for reducing the incidence of headaches after lumbar puncture. On the other hand, there are several misconceptions that are thought to decrease the incidence of headaches with no scientific basis. This article reviews the scientific literature and highlights the practical issues involved in the diagnosis and management of headaches after lumbar puncture, including the epidural blood patch treatment.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660496/pdf/713.pdf
No efecto en la duración del decúbito sobre la incidencia de CPPD debida a agujas cortantes G22
No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle.
Kim SR, Chae HS, Yoon MJ, Han JH, Cho KJ, Chung SJ.
Department of Nursing, Asan Medical Center, Seoul, South Korea.
BMC Neurol. 2012 Jan 30;12:1. doi: 10.1186/1471-2377-12-1.
Abstract
BACKGROUND: Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. METHODS: A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). RESULTS: The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). CONCLUSIONS: Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292507/pdf/1471-2377-12-1.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
