Post-Spinal Anesthesia Headache Treated with Caffeine. Part II

Sechzer, P. H.

doi:10.1097/00132586-198102000-00068

Cited by 47 publications

(66 citation statements)

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“…In a randomized double blind trial by Sechzer and Abel caffeine sodium benzoate 500mg intravenously had better relief of PDPH compared to placebo. 50 similarly, Camann et al observed that oral caffeine 300mg being superior to placbo for the relief of PDPH. 51 Caffeine is inexpensive, easy to obtain and fairly risk free.it is available in both oral and intra venous form.…”

Section: Caffeinementioning

confidence: 86%

Post Dural Puncture Headache

Deo

2013

J Chitwan Med Coll

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Spinal anaesthesia developed in the late 1800s. In 1891, Wynter and Quincke aspirated cerebrospinal fluid (CSF) from the subarachnoid space for the treatment of raised intracranial pressure associated with tuberculous meningitis. However it was German surgeon, August Bier, probably first gave spinal anaesthesia and also experienced headache. He first reported this headache being related to excessive loss of cerebrospinal fluid (CSF). Recently there are lots of modification in needle size and its tip which lead to sharp decline in the incidence of post dural puncture headache (PDPH). Various conservative, pharmacological and interventional measures are available. Epidural blood patch has high cure rate. Epidural saline, dextran, opioids, tissue glue are also been used to reduce rate of CSF loss. This review considers all these aspect of PDPH. Journal of Chitwan Medical College 2013; 3(1): 5-10 DOI: http://dx.doi.org/10.3126/jcmc.v3i1.8457

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Section: Caffeinementioning

confidence: 86%

Post Dural Puncture Headache

Deo

2013

J Chitwan Med Coll

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“…Epidural Hartmann's solution, epidural dextran and saline has been reported to reduce PDPH 6 .it has been suggested that placement of a spinal catheter( through the accidental dural perforation with a Tuohy needle), may provoke an inflammatory reaction which that will seal the hole. 7 Caffeine, sumatriptapan and theophylline has been shown to beneficial in relieving PDPH by cerebral vasoconstriction effect [8][9][10] .Another non invasive method to treat PDPH are bed rest, hydration ,abdominal binder, analgesics, and oral Gabapentine 400mg 11 tid has been reported to relieves pain within 24 hrs.. It is possible that postdural puncture headache left untreated may be complicated by the development of subdural hematoma.…”

Section: Discussion-mentioning

confidence: 99%

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Paswan¹

2012

iosrphr

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-Tracheal stenosis is the most common late airway complication of post intubation/trachestomy resulted in hemodynamic deterioration and impairment of respiratory system mechanics. Post-dural puncture headache (PDPH) is well known complication of introduction of spinal/epidural needle in subarachanoid space. In this article, we present a very rare case report of a patient 18 year old male, diagnosis tuberculous meningitis(TBM) get prolong mechanical ventilation and dural puncture had developed tracheal stenosis and post-dural puncture headache . We describe a patient with PDPH and tracheal stenosis which was initially misdiagnosed as simple headache and asthma after prolonged tracheal intubation. Surgery is lifesaving for patients with critical tracheal stenosis, but how to ensure effective gas exchange is crucial to the anesthetic management. KEY WORD:-TBM .PDPH .TRACHEAL STENOSIS CASE HISTORY:-A 18 year-old male who presented with a 6-week history of headache and fever and a 8-hour history of inability to speak and alteration in level of consciousness. There was history of neck pain, occasional nausea /vomiting and no neck stiffness .He had no other remarkable past history of medical and surgical illness. Before presentation, he had been kept on various intravenous antibiotics in private hospitals, with no clinical improvement. Physical examination showed a young man in an altered level of consciousness with signs of meningeal irritation and had left spastic hemiparesis. The patient had progressive respiratory distress with rapid shallow breathing, while using all accessory muscles of respiration. He had a respiratory rate of 35 breaths min -1 , and a fluctuating arterial oxygen saturation of 70~80% with 10 L.min -1 of supplementary oxygen. The patient was ventilated with the synchronized intermittent mandatory ventilation with volume controlled mode selected. The ventilatory settings were as follows: FiO 2 0.40; respiratory rate 14 breaths/min; Tidal volume500ml; pressure support 12 cm H 2 O; positive end expiratory pressure (PEEP) 5 cm H 2 O.With above mentioned settings, the peak airway pressure (PIP) was 16 cm H 2 O, and the arterial blood gas parameters were satisfactory .A lumbar puncture was performed with 23 G spinal needle and produced opalescent cerebrospinal fluid (CSF) with CSF pressure of 14 cm of H20. The biochemical/microbiological features of CSF are :-Protein 80mg/dl; glucose 40mg/dl; WBC 75 /micro L, chiefly there was Lymphocyte (70%)and CSF acid fast and grams staining were negative . CSF culture was not sent .The computed tomography scan of brain showed obstructive hydrocephalus. These above mentioned feature was suggestive of tuberculous meningitis .He was placed immediate on antituberculous drugs and intravenous steroids and mannitol .He was successfully weaned off mechanical ventilatory support after 10 days. After first day of weaning patient experienced of headache and vertigo. Intensivist assumed that headache and vertigo is a part of TBM and symptoms will subside after few da...

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“…Randomised controlled studies have been conducted to prove the effectiveness of caffeine. Published information on this treatment comes mainly from reviews that one study in 1979 [56]. This study was carried out in 41 patients in whom IV administration of 500mg of caffeine sodium benzoate relieved headache in 75% of the patients with further improvement observed with a second dose.…”

Section: Caffeinementioning

confidence: 99%

Perioperative Management of post dural puncture headache

Shaikh¹,

Ramesh²

2015

Int J of Biomed & Adv Res

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Post dural puncture headache (PDPH) is a common complication of interventional neuraxial procedures. It carries a considerable morbidity with symptoms lasting for several days, sometimes severe enough to immobilise the patient. If left untreated it can result in serious complication which may be fatal. It is therefore important that the doctors should aware of the methods available for reducing the incidence of PDPH. This article reviews the scientific literature involved in the management of PDPH including the epidural blood patch.

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Post-Spinal Anesthesia Headache Treated with Caffeine. Part II

Cited by 47 publications

References 0 publications

Post Dural Puncture Headache

Post Dural Puncture Headache

Atypical presentations of tuberculous meningitis patient on prolong mechanical ventilation: - A CASE REPORT

Perioperative Management of post dural puncture headache

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