DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ

Mustafa Soner Özcan

doi:10.17343/sdutfd.308231

DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ

Abstract

ÖZET: Dural ponksiyon, farklı birçok disiplin tarafından farklı amaçlar için sık uygulanan bir işlemdir. Anestezi pratiğinde dural ponksiyon en çok istemli olarak subaraknoid blok ve istemeden epidural anestezi sırasında gerçekleştirilir. Dura ponksiyonu sonrası baş ağrısı, August Bier’in 1898’de ilk vakayı bildirmesinden beri bu işlemden sonra ortaya çıkan sık ve ciddi komplikasyonlardan biridir. Son yıllarda geliştirilen küçük çaplı iğneler ve özellikle pencil-point tipi iğnelerde baş ağrısı insidansı geleneksel keskin Quinke tip iğnelere kıyasla oldukça azalmıştır. Baş ağrısı genel olarak 2 hafta içerisinde kaybolsa da, aylar ve hatta yıllarca sürebilir. Hastaların günlük yaşantısını ciddi anlamda bozan bu komplikasyon için değişik tedavi modaliteleri bulunmuştur. Bunlardan güncel olarak ‘’altın standart’’ yöntem olarak görülen epidural kan yamasıdır. Dura ponksiyonu sonrası baş ağrısı, farkedildiği andan itibaren dikkatlice izlenmeli, hızlıca tedavisine başlanmalıdır. İnvaziv yöntemler, konservatif yöntemlere cevap vermeyen vakalarda seçilmelidir. Oluşabilecek diğer hayatı tehlikeye sokabilecek komplikasyonlar açısından dikkatli olunmalı ve ayırıcı tanı yapılmalıdır.

ABSTRACT: Dural puncture is a common procedure used by many different disciplines for different purposes. In anesthesia practice, dural puncture is mostly performed during subarachnoid block as intentional and epidural anesthesia as unintentional. Post-dural puncture heacache has been one of the most frequent and serious complications since August Bier reported the first case in 1898. In recent years, the incidence of headaches with small gauge needles, especially pencil-point type needles, has been greatly reduced when compared to traditional cutting Quinke type needles. Although headache generally ceases within 2 weeks, it may last for months or even years. Various treatment modalities have been found for this complication that seriously impairs the daily life of the patients. One of the current methods is epidural blood patch which is regarded as ‘Gold Standard’. Post-dural puncture headache should be followed up carefully as from the moment that it is noticed, and treatment should be started quickly. Invasive methods should be chosen for the cases who are unresponsive to conservative methods. It should be careful for other life-threatening complications and definitive diagnosis should be made.

Keywords

Dura Ponksiyonu Sonrası Başağrısı,Epidural Kan Yaması,Komplikasyonlar,Tedavi

References

1. Spears RC. Low-pressure/spinal fluid leak headache. Current pain and headache reports. 2014;18(6):1-6.
2. Harrington BE. Postdural puncture headache and the development of the epidural blood patch. Regional anesthesia and pain medicine. 2004;29(2):136-63.
3. Greene HM. Lumbar puncture and the prevention of postpuncture headache. Journal of the American Medical Association. 1926;86(6):391-2.
4. Turnbull D, Shepherd D. Post‐dural puncture headache: pathogenesis, prevention and treatment. British journal of anaesthesia. 2003;91(5):718-29.
5. Fink BR, Walker S. Orientation of fibers in human dorsal lumbar dura mater in relation to lumbar puncture. Anesthesia & Analgesia. 1989;69(6):768-72.
6. Rozen TD. Pachymeningeal enhancement on MRI: a venous phenomena not always related to intracranial hypotension (resolving pachymeningeal enhancement and cerebral vein thrombosis). Headache: The Journal of Head and Face Pain. 2013;53(4):673-5.
7. Algin O, Taskapilioglu O, Zan E, Hakyemez B, Karaoglanoglu M. Detection of CSF leaks with magnetic resonance imaging in intracranial hypotension syndrome. Journal of Neuroradiology. 2011;38(3):175-7.
8. Halpern S, Preston R. Postdural puncture headache and spinal needle design. Metaanalyses. Anesthesiology. 1994;81(6):1376-83.

9. Lambert DH, Hurley RJ, Hertwig L, Datta S. Role of needle gauge and tip configuration in the production of lumbar puncture headache. Regional anesthesia and pain medicine. 1997;22(1):66-72.
10. Bezov D, Ashina S, Lipton R. Post‐dural puncture headache: Part II–prevention, management, and prognosis. Headache: The Journal of Head and Face Pain. 2010;50(9):1482-98.
11. Dittmann M, SCHAEFER HG, Renkl F, Greve I. Spinal anaesthesia with 29 gauge Quincke point needles and post dural puncture headache in 2,378 patients. Acta anaesthesiologica scandinavica. 1994;38(7):691-3.
12. Lybecker H, Møller JT, May O, Nielsen HK. Incidence and Prediction of Postdural Puncture Headache A Prospective Study of 1021 Spinal Anesthesias. Anesthesia & Analgesia. 1990;70(4):389-94.
13. Lynch J, Kasper S-M, Strick K, Topalidis K, Schaaf H, Zech D, et al. The use of Quincke and Whitacre 27-gauge needles in orthopedic patients: incidence of failed spinal anesthesia and postdural puncture headache. Anesthesia & Analgesia. 1994;79(1):125-8.
14. Geurts J, Haanschoten M, Wijk R, Kraak H, Besse T. Post‐dural puncture headache in young patients. A comparative study between the use of 0.52 mm (25‐gauge) and 0.33 mm (29‐gauge) spinal needles. Acta Anaesthesiologica Scandinavica. 1990;34(5):350-3.
15. Keener EB. An experimental study of reactions of the dura mater to wounding and loss of substance. Journal of neurosurgery. 1959;16(4):424-47.
16. Gormley J. Treatment of postspinal headache. Anesthesiology. 1960;21(5):565-6.
17. Reynolds F. Dural puncture and headache. BMJ: British Medical Journal. 1993;306(6882):874.
18. Sachs A, Smiley R, editors. Post-dural puncture headache: the worst common complication in obstetric anesthesia. Seminars in perinatology; 2014: Elsevier.
19. Kokki H, Heikkinen M, Turunen M, Vanamo K, Hendolin H. Needle design does not affect the success rate of spinal anaesthesia or the incidence of postpuncture complications in children. Acta anaesthesiologica scandinavica. 2000;44(2):210-3.
20. Evans RW. Complications of lumbar puncture. Neurologic clinics. 1998;16(1):83-105.
21. Liu S, Carpenter RL, Neal JM. Epidural Anesthesia and AnalgesiaTheir Role in Postoperative Outcome. The Journal of the American Society of Anesthesiologists. 1995;82(6):1474-506.
22. Ghaleb A, Khorasani A, Mangar D. Post-dural puncture headache. Int J Gen Med. 2012;5(12):45-51.
23. Leibold RA, Yealy DM, Coppola M, Cantees KK. Post-dural-puncture headache: characteristics, management, and prevention. Annals of emergency medicine. 1993;22(12):1863-70.
24. Bezov D, Lipton RB, Ashina S. Post‐Dural Puncture Headache: Part I Diagnosis, Epidemiology, Etiology, and Pathophysiology. Headache: The Journal of Head and Face Pain. 2010;50(7):1144-52.
25. Society HCSotIH. The international classification of headache disorders. cephalalgia. 2004;24(1):1-160.
26. Serpell M, Rawal N. Headaches after diagnostic dural punctures: Smaller, atraumatic needles and protocols for early treatment should reduce morbidity. British Medical Journal. 2000;321(7267):973-4.
27. Van de Velde M, Schepers R, Berends N, Vandermeersch E, De Buck F. Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric anaesthesia department. International journal of obstetric anesthesia. 2008;17(4):329-35.
28. Paech MJ, Doherty DA, Christmas T, Wong CA, Group EBPT. The volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial. Anesthesia & Analgesia. 2011;113(1):126-33.
29. Webb CA-J, Weyker PD, Zhang L, Stanley S, Coyle DT, Tang T, et al. Unintentional dural puncture with a Tuohy needle increases risk of chronic headache. Anesthesia & Analgesia. 2012;115(1):124-32.
30. Ho KY, Gan T. Management of persistent post‐dural puncture headache after repeated epidural blood patch. Acta Anaesthesiologica Scandinavica. 2007;51(5):633-6.
31. Spriggs D, Burn D, French J, Cartlidge N, Bates D. Is bed rest useful after diagnostic lumbar puncture? Postgraduate medical journal. 1992;68(801):581-3.
32. Thoennissen J, Herkner H, Lang W, Domanovits H, Laggner AN, Müllner M. Does bed rest after cervical or lumbar puncture prevent headache? A systematic review and meta-analysis. Canadian Medical Association Journal. 2001;165(10):1311-6.
33. Jones RJ. The role of recumbency in the prevention and treatment of postspinal headache. Anesthesia & Analgesia. 1974;53(5):788-96.
34. Handler CE, Perkin G, Smith F, Rose FC. Posture and lumbar puncture headache: a controlled trial in 50 patients. Journal of the Royal Society of Medicine. 1982;75(6):404-7.
35. Mosavy S, Shafei M. Prevention of headache consequent upon dural puncture in obstetric patient. Anaesthesia. 1975;30(6):807-9.
36. Camann WR, Murray RS, Mushlin PS, Lambert DH. Effects of Oral Caffeine on Postdural Puncture Headache: A Double-Blind, Placebo-Controlled Trial. Anesthesia & Analgesia. 1990;70(2):181-4.
37. Bolton VE, Leicht CH, Scanlon TS. Postpartum seizure after epidural blood patch and intravenous caffeine sodium benzoate. The Journal of the American Society of Anesthesiologists. 1989;70(1):146-8.
38. Basurto Ona X, Uriona Tuma SM, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for preventing post‐dural puncture headache. The Cochrane Library. 2013.
39. Bussone G, Tullo V, d'Onofrio F, Petretta V, Curone M, Frediani F, et al. Frovatriptan for the prevention of postdural puncture headache. Cephalalgia. 2007;27(7):809-13.
40. Collier B. Treatment for post dural puncture headache. British journal of anaesthesia. 1994;72(3):366-7.
41. Gupta S, Agrawal A. Postdural puncture headache and ACTH. Journal of clinical anesthesia. 1997;9(3):258.
42. Hakim SM. Cosyntropin for prophylaxis against postdural puncture headache after accidental dural puncture. The Journal of the American Society of Anesthesiologists. 2010;113(2):413-20.
43. Hanling SR, Lagrew JE, Colmenar DH, Quiko AS, Drastol CA. Intravenous Cosyntropin Versus Epidural Blood Patch for Treatment of Postdural Puncture Headache. Pain Medicine. 2016:pnw014.
44. Ergün U, Say B, Ozer G, Tunc T, Sen M, Tüfekcioglu S, et al. Intravenous theophylline decreases post-dural puncture headaches. Journal of clinical neuroscience. 2008;15(10):1102-4.
45. Mahoori A, Hassani E, Noroozinia H, Javaheri N, Hatami S. Theophylline versus acetaminophen in the treatment of post-dural puncture headache (PDPH). Middle East J Anesthesiol. 2013;22(3):289-92.
46. Beards S, Jackson A, Griffiths A, Horsman E. Magnetic resonance imaging of extradural blood patches: appearances from 30 min to 18 h. British journal of anaesthesia. 1993;71(2):182-8.
47. Djurhuus H, Rasmussen M, Jensen E. Epidural blood patch illustrated by CT‐epidurography. Acta anaesthesiologica scandinavica. 1995;39(5):613-7.
48. Rucklidge MW. All patients with a postdural puncture headache should receive an epidural blood patch. International journal of obstetric anesthesia. 2014;23(2):171-4.
49. Lavi R, Rowe J, Avivi I. Lumbar puncture: it is time to change the needle. European neurology. 2010;64(2):108-13.
50. Booth J, Pan P, Thomas J, Harris L, D’Angelo R. A retrospective review of an epidural blood patch database: the incidence of epidural blood patch associated with obstetric neuraxial anesthetic techniques and the effect of blood volume on efficacy. International Journal of Obstetric Anesthesia. 2017;29:10-7.
51. Pleasure SJ, Abosch A, Friedman J, Ko N, Barbaro N, Dillon W, et al. Spontaneous intracranial hypotension resulting in stupor caused by diencephalic compression. Neurology. 1998;50(6):1854-7.
52. Apfel C, Saxena A, Cakmakkaya O, Gaiser R, George E, Radke O. Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic review. British journal of anaesthesia. 2010;105(3):255-63.
53. Boonmak P, Boonmak S. Epidural blood patching for preventing and treating post‐dural puncture headache. The Cochrane Library. 2010.
54. Bradbury C, Singh S, Badder S, Wakely L, Jones P. Prevention of post‐dural puncture headache in parturients: a systematic review and meta‐analysis. Acta Anaesthesiologica Scandinavica. 2013;57(4):417-30.
55. Stein M, Cohen S, Mohiuddin M, Dombrovskiy V, Lowenwirt I. Prophylactic vs therapeutic blood patch for obstetric patients with accidental dural puncture–a randomised controlled trial. Anaesthesia. 2014;69(4):320-6.
56. Stride P, Cooper G. Dural taps revisited. Anaesthesia. 1993;48(3):247-55.
57. Trivedi NS, Eddi D, Shevde K. Headache prevention following accidental dural puncture in obstetric patients. Journal of clinical anesthesia. 1993;5(1):42-5.
58. USUBIAGA JE, MOYA F, USUBIAGA LE. Effect of thoracic and abdominal pressure changes on the epidural space pressure. British journal of anaesthesia. 1967;39(8):612-8.
59. Bart AJ, Wheeler AS. Comparison of epidural saline placement and epidural blood placement in the treatment of post-lumbar-puncture headache. The Journal of the American Society of Anesthesiologists. 1978;48(3):221-3.
60. Lander C, Korbon G. Histopathologic consequences of epidural blood patch and epidurally administered Dextran 40. The Journal of the American Society of Anesthesiologists. 1988;69(3A):A410-A.
61. Devcic A, MAITRA-D'CRUZE A, SPRUNG J, PATEL S, KETTLER R. PDPH in obstetric anesthesia: comparison of 24-gauge Sprotte and 25-gauge Quincke needles and effect of subarachnoid administration of fentanyl. Regional Anesthesia and Pain Medicine. 1993;18(4):222-5.
62. Al‐metwalli R. Epidural morphine injections for prevention of post dural puncture headache. Anaesthesia. 2008;63(8):847-50.
63. Heather Suescun D, Austin CP, Gabaldon CD. Nonpharmacologic Neuraxial Interventions for Prophylaxis of Postdural Puncture Headache in the Obstetric Patient. AANA journal. 2016;84(1):15.

Details

Primary Language

English

Subjects

Clinical Sciences

Journal Section

Review

Authors

Mustafa Soner Özcan
Servergazi Devlet Hastanesi
Türkiye

Publication Date

March 1, 2018

Submission Date

April 24, 2017

Acceptance Date

-

Published in Issue

Year 2018 Volume: 25 Number: 1

DOI

https://doi.org/10.17343/sdutfd.308231

IZ

https://izlik.org/JA46JY72ZT

Cite

RIS / Bibtex

APA

Özcan, M. S. (2018). DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ. Medical Journal of Süleyman Demirel University, 25(1), 98-107. https://doi.org/10.17343/sdutfd.308231

AMA

1.Özcan MS. DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ. Med J SDU. 2018;25(1):98-107. doi:10.17343/sdutfd.308231

Chicago

Özcan, Mustafa Soner. 2018. “DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ”. Medical Journal of Süleyman Demirel University 25 (1): 98-107. https://doi.org/10.17343/sdutfd.308231.

EndNote

Özcan MS (March 1, 2018) DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ. Medical Journal of Süleyman Demirel University 25 1 98–107.

IEEE

[1]M. S. Özcan, “DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ”, Med J SDU, vol. 25, no. 1, pp. 98–107, Mar. 2018, doi: 10.17343/sdutfd.308231.

ISNAD

Özcan, Mustafa Soner. “DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ”. Medical Journal of Süleyman Demirel University 25/1 (March 1, 2018): 98-107. https://doi.org/10.17343/sdutfd.308231.

JAMA

1.Özcan MS. DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ. Med J SDU. 2018;25:98–107.

MLA

Özcan, Mustafa Soner. “DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ”. Medical Journal of Süleyman Demirel University, vol. 25, no. 1, Mar. 2018, pp. 98-107, doi:10.17343/sdutfd.308231.

Vancouver

1.Mustafa Soner Özcan. DURA PONKSİYONU SONRASI BAŞ AĞRISI VE TEDAVİSİ. Med J SDU. 2018 Mar. 1;25(1):98-107. doi:10.17343/sdutfd.308231

Cited By

Post Dural Ponksiyon Baş Ağrısında Hemşirelik Yaklaşımları

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi

https://doi.org/10.37989/gumussagbil.977887