Treatment Method To A Patıent After Occurance Of Dural Puncture Durıng Epıdural

Yıl 2011, Cilt: 1 Sayı: 2, - , 01.06.2011

Serkan Doğru

Öz

Occurance of dural puncture during epidural anaesthesia is a rare complication of epidural anaesthesia. In Our case, we entered into subarachnoid space during epidural anaesthesia and free flow of cerebro-spinal fluid was seen. Epidural needle was withdrawn to epidural space until the flow of cerebro-spinal fluid was not seen. After the epidural space was confirmed by injection aspiration technique with physiological serum, 20 ml autologous blood was taken and epidural blood patch was performed by injecting it into the epidural space. After any complications was not occured at peroperative period, the patient was transferred to his clinic. The patient was discharged after 48 hours of follow-up without any occurance of headache.

Anahtar Kelimeler

Epidural anaesthesia, epidural blood patch, dural puncture

EPİDURAL ANESTEZİ SIRASINDA DURAL YIRTIK OLUŞAN BİR HASTAYA UYGULANAN TEDAVİ YÖNTEMİ

Öz

Epidural anestezi sırasında dural yırtık oluşması, epidural anestezinin nadir komplikasyonlarındandır. Olgumuzda epidural anestezi uygulanırken subaraknoid aralığa girildi ve serbest beyin omurilik sıvısı akışı görüldü. Epidural iğne beyin omurilik sıvısı akışının görülmediği epidural aralığa kadar geri çekildi ve serum fizyolojik ile enjeksiyon aspirasyon yöntemi kullanılarak epidural aralık doğrulandıktan sonra, hastadan 20 ml otolog kan alındı ve epidural aralığa verilerek epidural kan yaması yapıldı. Peroperatif herhangi bir komplikasyon gelişmeyen hasta, sorunsuz olarak servisine devredildi. 48 saat izlenen hastada başağrısı gelişmemesi üzerine taburcu edildi.

Anahtar Kelimeler

Epidural anestezi, epidural kan yaması, dura yırtılması

Kaynakça

• Apfel CC, Saxena A, Cakmakkaya OS, et al. Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic review Br J Anaesth 2010;105(3): –63.
• Scavone BM, Wong CA, Sullivan JT, et al. Efficacy of a Prophylactic Epidural Blood Patch in Preventing Post Dural Puncture Headache in Parturients after Inadvertent Dural ;101:1422–7. Anesthesiology
• Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment Br J Anaesth 2003;91(5):718
• Apfel CC, Saxena A, Çakmakkaya OS, et al. Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic ;105:255-63. Review. Safa-Tisseront V, Thorman F, Malassine P, et al. Effectiveness of Epidural Blood Patch in the Management of Post-Dural Puncture Headache Anesthesiology 2001;95:334-9. Br J Anaesth Colonna-Romano P, Shapiro BE. and Unintentional
• Prophylactic Epidural Obstetrics Anesth Analg 1989;69:522-3.
• Kooten F, Oedit R, Bakker SLM, et al. Epidural blood patch in post dural puncture headache: a randomised, observer blind, controlled clinical trial J Neurol Neurosurg Psychiatry 2008;79:553-8.
• Sudlow C, Warlow C. Epidural blood patching for preventing and treating post- dural puncture headache The Cochrane Database ;2:CD001791. Review.
• Boonmak P, Boonmak S. Epidural blood patching for preventing and treating post- dural puncture headache The Cochrane Database ;20:1791-9. Review. Puncture Blood Patch in of Systematic Reviews of Systematic Reviews