Decreased incidence of headache after unintentional dural puncture in patients with cesarean delivery administered with postoperative epidural analgesia

Cesur, Mehmet; Alici, Hacı Ahmet; Erdem, Alı Fuat; Silbir, Fikret; Çelik, Mine

doi:10.1007/s00540-008-0690-7

Cited by 20 publications

(18 citation statements)

References 30 publications

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“…Two other retrospective studies of ADP in relation to elective caesarean delivery under attempted epidural anaesthesia suggest another possible reason for reduced PDPH and EBP rates with operative deliveries. 23,24 In one study some patients had an intrathecal catheter placed after the ADP and this remained in situ for more than 24 h. 23 In the other, some patients had the epidural catheter reinserted and this remained in situ for postoperative analgesia: 24 the other patients in this latter study received either general or single-shot spinal anaesthesia for surgery. Both studies noted a significant reduction in PDPH and EBP rates in patients with a neuraxial catheter, whether epidural or intrathecal.…”

Section: Discussionmentioning

confidence: 98%

A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour

Russell

2012

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 98%

A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour

Russell

2012

International Journal of Obstetric Anesthesia

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“…This syndrome could be primary (idiopathic) or secondary to a variety of causes and could be the result of inadvertent dural puncture during epidural analgesia (0.26–2%) [2]. …”

Section: Discussionmentioning

confidence: 99%

Intracranial hypotension and PRES: case report

et al. 2010

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We report a case of a woman presenting, 7 days after epidural analgesia for a caesarean section, to the emergency room for a worsening of the headache and tonico-clonic seizures. MRI showed alterations suggestive of the presence of intracranial hypotension (IH) as well as evidence of posterior reversible encephalopathy syndrome (PRES). She was treated with a blood patch which leads to the prompt regression of the clinical symptoms and follow-up MRI, after 15 days, showed complete resolution of radiological alterations. The possible pathogenetic relationship between IH, secondary to the inadvertent dural puncture, and PRES is discussed. We suggest that venous stagnation and hydrostatic edema, secondary to intracranial hypotension, probably played a crucial role in the pathogenesis of PRES.

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“…Recently, epidural morphine via thoracic catheter was used for postoperative pain relief following resection of oral malignant tumors [41]. Moreover, it was reported that epidural morphine injections were effective in decreasing the incidence of headache after inadvertent dural puncture [42].…”

Section: Opioidsmentioning

confidence: 99%

New Drugs for Epidural Analgesia

Congedo

Sgreccia

Cosmo

2009

CDT

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In recent years there has been a wide use of the epidural technique not only during surgery to provide anesthesia and analgesia, but also for obstetric and trauma as well as acute, chronic and cancer pain states. Nowadays there is an increase in the number of the epidural drugs. Local anesthetics and opioids are still the pharmacological agents more widely used epidurally, nevertheless other drugs from different pharmacological classes are administered as adjuvant to local anesthetics and opioids or are in various early stages of investigation. Regarding to local anesthetics, the most recent literature focuses on the new enantiomers, ropivacaine and levobupivacaine, the efficacy of which is similar to that of bupivacaine with a reduced risk of cardiotoxicity. About opioids, the other class of drugs mainly used, the debate, in the last years, concerned the physicochemical properties of morphine and of the more recent lipophilic agents, fentanyl and sufentanil, in order to explain the main differences in efficacy and safety. Other categories of agents have been investigated for epidural administration, such as alpha(2)-adrenergic agonists clonidine and dexmedetomidine. They are being used increasingly as adjuvants to local anesthetics and opioids. Ketamine and neostigmine, the more recent studied drugs for epidural use, are still under investigation and are not part of routine clinical practice.

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Decreased incidence of headache after unintentional dural puncture in patients with cesarean delivery administered with postoperative epidural analgesia

Abstract: Subsequent catheter placement into the epidural space after unintentional dural puncture in cesarean delivery and leaving the catheter for postoperative analgesia for 36-72 h may reduce the incidence of PDPH.

Cited by 20 publications

References 30 publications

A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour

A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour

Intracranial hypotension and PRES: case report

New Drugs for Epidural Analgesia

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