Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia
Kyu Chang Lee,
Dae-Jeong Koo,
Won Sang Lee,
Hye Young Kim,
Yusun Choi,
Myeong Jong Lee
Issue:
Volume 3, Issue 4, July 2015
Pages:
14-16
Received:
26 August 2015
Accepted:
21 September 2015
Published:
12 October 2015
Abstract: Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.
Abstract: Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintena...
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