Intrathecal Catheter Insertion After Unintentional Dural Puncture

Abstract

Epidural analgesia is a common method of pain relief during labour and delivery . Furthermore a combination of spinal and epidural technique is still a reasonable choice for use in patients treated with orthopedic surgeries as total hip and knee replacements. Prophylactic measures have been attempted after accidental dural puncture with an epidural needle because of the high risk of developing post-dural puncture headache (PDPH). Conservative managment usually includes hydration with iv or oral fluids and analgesic medication. Many reports have suggested that leaving the catheter in the dural hole for several hours may decrease the incidence of PDPH. In that case report ; after unintentional dural puncture, inserting the catheter through the dural tear, maintaining intrathecal analgesia and leaving the catheter in place for 20 hours presented. Key words: Post-Dural Puncture Headache, İntentional Dural Puncture, Epidural Needle, İntrathecal Catheter

Keywords

• Post-Dural Puncture Headache, İntentional Dural Puncture, Epidural Needle, İntrathecal Catheter

İstenmeyen Dura Ponksiyonu Sonrası İntratekal Kateter Yerleştirilmesi: Olgu Sunumu

Öz

Epidural analjezi doğum ve doğum ağrısı sırasında ağrının önlenmesinde yaygın bir yöntemdir. Ayrıca kombine spinal epidural teknik hala total kalça ve diz protezi gibi ortopedik cerrahi hastalarının tedavisinde kullanmak için mantıklı bir tercihtir. Epidural iğne ile kazara dural ponksiyon sonrası postdural ponksiyon başağrısı (PPB) insidansının yüksek olması nedeniyle profilaktik tedbirler alınmaktadır. Koruyucu yönetim genellikle iv veya oral sıvı replasmanı ve analjezik tedaviyi içerir. Birçok çalışma kateterin birkaç saatliğine dural delikte bırakılmasının PPB insidansını azaltabileceğini göstermiştir. Bu olguda; istenmeyen dural ponksiyon sonrası dural yırtıktan kateterin yerleştirilmesi, intratekal analjezinin sürdürülmesi ve 20 saat boyunca kateterin intratekal alanda bırakılması sunuldu. Anahtar kelimeler: Postdural Ponksiyon Başağrısı, İstenmeyen Dural Ponksiyon, Epidural İğne, İntratekal Kateter

Anahtar Kelimeler

• Postdural Ponksiyon Başağrısı, İstenmeyen Dural Ponksiyon, Epidural İğne, İntratekal Kateter

Kaynakça

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