Sezaryen Geçiren Hastalarda İntratekal Enjeksiyon Hızının Post-Dural Ponksiyon Baş Ağrısı Üzerine Etkisi: Prospektif, Randomize Çalışma

Öz

Amaç: Bu çalışmada sezaryen geçiren hastalarda intratekal enjeksiyon hızının post-dural ponksiyon baş ağrısı (PDPBA) üzerine etkisinin değerlendirilmesi amaçlanmıştır.                                                     

Materyal ve Metot: Spinal anestezi ile sezaryen operasyonu planlanan 18-45 yaş arasında 140 hasta randomize olarak 2 gruba ayrılmıştır. Oturur pozisyonda L4-L5 seviyesinden, median girişle,  25G Quincke spinal iğne ile 10 mg hiperbarik 0.5% bupivakaine; Grup I’deki hastalara intratekal enjeksiyon olabildiğince hızlı bir şekilde uygulandı ve Grup II’deki hastalara intratekal enjeksiyon ile 40 sn içinde uygulandı. İntraoperatif dönemde hemodinamik verileri, efedrin kullanımı ve bulantı-kusma sıklığı kaydedildi. İşlem tarihinden 7 gün sonra hastalar telefon ile aranıp PDPBA yönünden sorgulandı. PDPBA’nın sorgulanmasında ICHD-III kriterleri kullanıldı. 

Bulgular: Gruplar arasında karşılaştırmada PDPBA insidansı (Grup I: %29.0 ve Grup II: %31.4) ve şiddeti açısından anlamlı bir fark bulunamamıştır (p>0.05). Hemodinamik veriler, efedrin kullanımı, bulantı kusma görülme sıklığı karşılaştırıldığında gruplar arasında anlamlı bir fark gözlenmemiştir (p>0.05).

Sonuç: Spinal anestezi ile sezaryen geçiren gebelerde, hiperbarik bupivakainin intratekal alana farklı hızlarda verilmesinin; PDPBA sıklığını ve şiddetini, hemodinamik parametreleri, efedrin gereksinimi ve bulantı kusma sıklığını etkilemediği kanaatindeyiz.

Anahtar Kelimeler

• Spinal anestezi,post dural ponksiyon baş ağrısı,sezaryen

Effect of Intrathecal Injection Speed on Post-Dural Puncture Headache in Parturients Undergoing Cesarean Section: A Prospective, Randomized Study

Abstract

Aim: In this study, it was aimed to evaluate the effect of intrathecal injection rate on post- dural puncture headache (PDPH) in cesarean patients.

Material and Methods: 140 patients between 18-45 years of age who were scheduled for caesarean section with spinal anesthesia were randomly divided into two groups. From the L4-L5 level in the sitting position, 10 mg hyperbaric 0.5% bupivacaine with a 25 G Quincke spinal needle, median inlet; Intrathecal injection was performed as quickly as possible in the patients in Group I and administered to patients in Group II by intrathecal injection in 40 seconds. Hemodynamic data, ephedrine use and frequency of nausea and vomiting were recorded intraoperatively. 7 days after the procedure, the patients were called by phone and questioned for PDPH. The ICHD-III criteria were used to question the PDPH.

Results: There was no significant difference in the incidence of postdural headache (Group I: 29.0% and Group II: 31.4%) and severity (p> 0.05). There was no significant difference between the groups when haemodynamic data, ephedrine usage, nausea and vomiting frequency were compared (p> 0.05).

Conclusion: In the cases of cesarean section with spinal anesthesia, hyperbaric bupivacaine is given to the intrathecal area at different rates; We conclude that PDPH frequency and severity do not affect haemodynamic parameters, ephedrine requirement and frequency of nausea and vomiting.

Keywords

• Spinal anesthesia,post-dural puncture headache,cesarean section

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