Br J Anaesth:翼腭神经节阻滞治疗硬膜外穿刺头痛

2020-08-08 MedSci原创 MedSci原创

目前治疗硬膜外穿刺后头痛的方法包括硬膜外血补片(EBP),但是这种方法有创,可能导致罕见且严重的并发症。脊神经节阻滞是一种简单、微创的治疗硬膜外穿刺后头痛的方法。本研究旨在研究局部麻醉VS生理盐水经翼

目前治疗硬膜外穿刺后头痛的方法包括硬膜外血补片(EBP),但是这种方法有创,可能导致罕见且严重的并发症。脊神经节阻滞是一种简单、微创的治疗硬膜外穿刺后头痛的方法。本研究旨在研究局部麻醉VS生理盐水经翼腭神经节阻滞的镇痛效果。

 

研究纳入符合EBP标准的成年人,参与者接受1ml局部麻醉剂(利多卡因4%和罗哌卡因0.5%)或安慰剂(生理盐水)的双侧翼腭神经节阻滞。主要结局是阻滞后30分钟直立位的疼痛,使用0-100mm VAS测量。

 

随机分配了40名患者至局部麻醉组和安慰剂组,基线时两组患者直立位疼痛强度中位数分别为74和84 mm。翼腭神经节阻滞后30分钟,局部麻醉组直立位中位疼痛强度为26 mm ,安慰剂组为37 mm(中位差异为5 mm;95%置信区间:-14~21;P=0.53)。在局部麻醉组,50%需要进行EBP,而安慰剂组为45%(P=0.76)。

 

综上所述,该研究结果表明,与安慰剂相比,局部麻醉法进行翼腭神经节阻滞并没有降低30分钟后的疼痛强度。但两组中半数患者疼痛减轻,避免了EBP的发生,说明其主要作用不一定归于局部麻醉剂。

 

原始出处:

 

Mads S JespersenPia Jaeger, et al., Sphenopalatine ganglion block for the treatment of postdural puncture headache: a randomised, blinded, clinical trial. Br J Anaesth. 2020 Jun;124(6):739-747. doi: 10.1016/j.bja.2020.02.025. 

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    2021-06-20 AspirantSuo
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    2020-08-14 1489b2e8m42暂无昵称

    还可以

    0

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    2020-08-10 rgjl

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