Post-dural puncture headache research.doc

 PAGE \* MERGEFORMAT 4 Post-dural puncture headache research Dural puncture epidural anesthesia is the most common accidents and complications, in addition to lead block and the whole plane is too high spinal anesthesia, the highest incidence of headache. August Bier in 1898 for research of cocaine into the subarachnoid space for spinal anesthesia for the first time to describe this. According to reports, Bier doctors have felt a good effect, until the next morning found that patients with orthostatic headache, headache after supine will be reduced, and therefore lodged a hypothesis that the headaches are caused due to loss of cerebrospinal fluid. A symptom of the International Headache Society definition of PDPHA is within 7 days after lumbar puncture headache, and the puncture within 14 days after the disappearance. Vertical headache will be increased within 15 min, then again in 30 min supine disappear or eased. Pain usually occurs in the frontal, occipital, or two have emerged, sometimes in the shoulder and neck. Generally speaking, more headaches occurred in the 48 h period, but 25% of cases occurred in three days. There are researchers followed a total of 10098 times received spinal anesthesia in 8460 patients, the needle are Quinke used needles in size from 16 G to 24 G range. Results 72% of headache in 7 days to eliminate them; 87% in 6 months, removed more than 6 months duration of the headache all passed successfully treated with epidural blood patch. The duration of headaches with the needle on the model, some pairs of 730 cases of use of 26 G or 27 G needle spinal anesthesia in patients observed that the average duration of headache, with 26 G needle was 4.9 days, with 27 G needle for 3.8 days. PDPHA Other associated symptoms are nausea, vomiting, visual disturbances, hearing and changes. Vandam and Dripps that the visual impairment due to abducens nerve palsy; Lybecker noted PDPHA the incidence of visual impairment in patients was 14%, he thinks