产科患者硬穿刺后的体外导管：减少硬穿刺后头痛的安全性和有效性

IF 0.9 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-04-01 DOI:10.1016/j.redar.2024.501671

G. Moreno Giménez, M.C. Melo Cruz, M. Ferrándiz Mach, S. Sabaté Tenas

{"title":"产科患者硬穿刺后的体外导管：减少硬穿刺后头痛的安全性和有效性","authors":"G. Moreno Giménez, M.C. Melo Cruz, M. Ferrándiz Mach, S. Sabaté Tenas","doi":"10.1016/j.redar.2024.501671","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR: 0.84; <em>P</em>  =.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing PDPH incidence, their use is safe and provides quality analgesia with rapid onset.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 4","pages":"Article 501671"},"PeriodicalIF":0.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural\",\"authors\":\"G. Moreno Giménez, M.C. Melo Cruz, M. Ferrándiz Mach, S. Sabaté Tenas\",\"doi\":\"10.1016/j.redar.2024.501671\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.</div></div><div><h3>Results</h3><div>Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR: 0.84; <em>P</em>  =.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1month.</div></div><div><h3>Conclusions</h3><div>Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing PDPH incidence, their use is safe and provides quality analgesia with rapid onset.</div></div>\",\"PeriodicalId\":46479,\"journal\":{\"name\":\"Revista Espanola de Anestesiologia y Reanimacion\",\"volume\":\"72 4\",\"pages\":\"Article 501671\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Espanola de Anestesiologia y Reanimacion\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0034935624001506\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Anestesiologia y Reanimacion","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0034935624001506","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：意外硬膜穿刺（ADP）后硬膜穿刺头痛（PDPH）是产科镇痛的常见并发症。有研究表明，ADP后插入鞘内导管（ITC）可能降低PDPH的发生率和治疗性硬膜外血贴（EBP）的需要。我们的主要目的是评估ADP后插入ITC是否能降低产科患者PDPH的发生率。次要目标包括评估EBP要求和与tc相关的并发症。方法：我们对2018年1月至2022年12月期间分娩镇痛期间记录在案的所有ADP产科患者进行了回顾性研究。将ITC与重复硬膜外麻醉患者的数据进行比较。结果在我们5年的研究期间，记录了35例ADP。其中，16例（45.7%）患者接受了24小时的ITC， 19例（54.3%）患者接受了硬膜外重新定位。ITC组与硬膜外组的PDPH发生率无显著差异(62.5% vs 68.4%；RR: 0.84;P = .713)， EBP要求也没有差异(18.8% vs 31.6%；RR: 0.84;p = .387)。随访时间组间无显著差异，1个月内未见tc相关并发症。结论：我们的研究结果与先前报道的文献一致，表明倾向于ITC的使用。除了降低PDPH发生率的潜在益处外，它们的使用是安全的，并提供快速起效的高质量镇痛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural

查看原文本刊更多论文

Catéter intratecal tras punción dural en pacientes obstétricas: Seguridad y efectividad en la reducción de la cefalea post punción dural

Background

Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.

Methods

We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.

Results

Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24 hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR: 0.84; P = .713), nor in EBP requirement (18.8% vs 31.6%; RR: 0.84; P = .387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1 month.

Conclusions

Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing PDPH incidence, their use is safe and provides quality analgesia with rapid onset.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊