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https://www.readbyqxmd.com/read/28823090/epidural-patch-with-autologous-platelet-rich-plasma-a-novel-approach
#1
Berrin Gunaydin, Muberra Acar, Gokcen Emmez, Didem Akcali, Nil Tokgoz
We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. Cranial MRI with contrast showed diffuse pachymeningeal thickening and contrast enhancement with enlarged pituitary consistent with intracranial hypotension...
August 19, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28739062/effect-of-head-and-neck-immobilization-on-postspinal-headache-a-randomized-controlled-trial
#2
Özgür Sema Culhacı, Gülçin Avşar
PURPOSE: The purpose of the study was to determine the effect of head and neck immobilization on postdural puncture headache (PDPH) through the use of cervical collars. DESIGN: This was a fully randomized controlled trial. METHOD: The sample group of the study consisted of 120 patients. Patients in the experimental group were followed up by using the appropriate cervical collar after the operation. The cervical collar was kept on until mobilization...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28690464/post-dural-puncture-headache-is-uncommon-in-young-ambulatory-surgery-patients
#3
Kathryn DelPizzo, Jennifer Cheng, Naomi Dong, Chris R Edmonds, Richard L Kahn, Kara G Fields, Jodie Curren, Valeria Rotundo, Victor M Zayas
BACKGROUND: The incidence of post-dural puncture headache (PDPH) arising from spinal anesthesia in the general population is low. However, patients under 45 years have been shown to exhibit a higher incidence of PDPH, even with small needles. QUESTIONS/PURPOSES: This study aimed to estimate the incidence of PDPH from a 27G pencil-point needle in ambulatory surgery patients between the ages of 15-45 years and compare incidence of PDPH by age group, sex, and history of headache...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28678882/insertion-of-an-intrathecal-catheter-in-parturients-reduces-the-risk-of-post-dural-puncture-headache-a-retrospective-study-and-meta-analysis
#4
Jiali Deng, Lizhong Wang, Yinfa Zhang, Xiangyang Chang, Xingjie Ma
This study aimed to determine whether insertion of an intrathecal catheter following accidental dural puncture (ADP) in obstetric patients can reduce the incidence of post-dural puncture headache (PDPH) and the requirement of a therapeutic epidural blood patch (TEBP). This was also compared with relocating the epidural catheter at a different vertebral interspace. A retrospective study was performed, as well as a meta-analysis of the literature to further validate our findings. We reviewed the records of 86 obstetric patients who suffered from ADP during epidural anesthesia or combined spinal-epidural anesthesia from October 2015 to November 2016 at our institution...
2017: PloS One
https://www.readbyqxmd.com/read/28663641/the-postdural-puncture-headache-and-back-pain-the-comparison-of-26-gauge-atraucan-and-26-gauge-quincke-spinal-needles-in-obstetric-patients
#5
Mehmet Salim Akdemir, Ayhan Kaydu, Yonca Yanlı, Mehtap Özdemir, Erhan Gökçek, Haktan Karaman
BACKGROUND: The postdural puncture headache (PDPH) and postdural puncture backache (PDPB) are well-known complications of spinal anesthesia. There are some attempts to reduce the frequency of complication such as different design of the spinal needles. AIMS: The primary outcome of this study is to compare the incidence of PDPH between 26-gauge Atraucan and 26-gauge Quincke spinal needles in elective cesarean operations. The severity of symptoms, the incidence of backache, technical issues, and comparison of cost of needles are secondary outcomes...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28535561/effectiveness-of-lateral-decubitus-position-for-preventing-post-dural-puncture-headache-a-meta-analysis
#6
Andres Zorrilla-Vaca, Jeetinder Kaur Makkar
BACKGROUND: Post-dural puncture headache (PDPH) is a relatively common complication of lumbar punctures for spinal anesthesia or neurologic diagnosis. For many years, a high number of drugs has been evaluated to treat PDPH, yet there is a minority to prevent this complication. The lateral decubitus position instead of sitting position during lumbar puncture has become an interesting approach because of its feasibility and patient satisfaction. OBJECTIVES: In this meta-analysis we hypothesized that lateral decubitus position is an effective manner to prophylactically reduce the incidence of PDPH...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#7
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28466552/greater-occipital-nerve-treatment-in-the-management-of-spontaneous-intracranial-hypotension-headache-a-case-report
#8
G Niraj, Peter Critchley, Mahesh Kodivalasa, Mohammed Dorgham
BACKGROUND: Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. METHODS: A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life...
June 2017: Headache
https://www.readbyqxmd.com/read/28440948/novel-reduction-sensitive-micellar-nanoparticles-assembled-from-rituximab-doxorubicin-conjugates-as-smart-and-intuitive-drug-delivery-systems-for-the-treatment-of-non-hodgkin-s-lymphoma
#9
Huabin Yin, Tong Meng, Ling Shu, Min Mao, Lei Zhou, Haiyan Chen, Dianwen Song
In this study, a novel reduction-sensitive drug delivery system, the Rituximab-Doxorubicin (RTX-DOX) micellar nanoparticle (RDMN), was specially designed for targeted delivery and release of DOX in Non-Hodgkin's Lymphoma (NHL) cells. The RDMN was fabricated by self-assembling of amphiphilic RTX-DOX conjugates (RDCs), which were synthesized by conjugating the hydrophilic Fab fragments of RTX (an anti-CD20 monoclonal antibody) and hydrophobic DOXs by a reduction-responsive linker, 3-(2-Pyridyldithio) propionyl hydrazide (PDPH)...
April 25, 2017: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/28416992/sphenopalatine-ganglion-block-for-relieving-postdural-puncture-headache-technique-and-mechanism-of-action-of-block-with-a-narrative-review-of-efficacy
#10
REVIEW
Abhijit S Nair, Basanth Kumar Rayani
The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28388808/needle-gauge-and-tip-designs-for-preventing-post-dural-puncture-headache-pdph
#11
REVIEW
Ingrid Arevalo-Rodriguez, Luis Muñoz, Natalia Godoy-Casasbuenas, Agustín Ciapponi, Jimmy J Arevalo, Sabine Boogaard, Marta Roqué I Figuls
BACKGROUND: Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH...
April 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28383416/comparison-of-cutting-and-pencil-point-spinal-needle-in-spinal-anesthesia-regarding-postdural-puncture-headache-a-meta-analysis
#12
Hong Xu, Yang Liu, WenYe Song, ShunLi Kan, FeiFei Liu, Di Zhang, GuangZhi Ning, ShiQing Feng
BACKGROUND: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28367283/postdural-puncture-headache
#13
REVIEW
Kyung-Hwa Kwak
Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28364968/-sphenopalatine-ganglion-block-for-postdural-puncture-headache-in-ambulatory-setting
#14
José Miguel Cardoso, Miguel Sá, Rita Graça, Hugo Reis, Liliana Almeida, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Postdural puncture headache (PDPH) is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Supportive therapy is the usual initial approach. Epidural blood patch (EBP) is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB) may be a safer alternative. CASE REPORT: We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before...
May 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28360535/assessment-of-risk-factors-for-postdural-puncture-headache-in-women-undergoing-cesarean-delivery-in-jordan-a-retrospective-analytical-study
#15
Wail N Khraise, Mohammed Z Allouh, Khaled M El-Radaideh, Raed S Said, Anas M Al-Rusan
PURPOSE: Postdural puncture headache (PDPH) is one of the most recognized complications after spinal anesthesia in women undergoing cesarean delivery. This study aimed to investigate the incidence of PDPH and its associated risk factors in women undergoing cesarean delivery in Jordan. PATIENTS AND METHODS: This study included all women who underwent cesarean delivery at King Abdullah University Hospital in Jordan during 2015. Patient characteristics including age, weight, occurrence of PDPH, needle type, repeated puncture attempt, history of spinal anesthesia and PDPH, presence of tension headache, preeclampsia, migraine, sinusitis, and caffeine withdrawal were collated from hospital records...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28262401/natural-history-of-headache-in-patients-with-lymphocytic-meningitis-following-lumbar-puncture
#16
Alexander Khlebtovsky, Shlomit Yust-Katz, Arieh Kuritzky, Israel Steiner
BACKGROUND: Analysis of cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) is essential for diagnosis of meningitis. What is the impact of the procedure upon the natural history of headache and associated signs in patients with lymphocytic meningitis and what factors can have prognostic value for the future progression of symptomatology? This study was aimed at looking into these questions. METHODS: One hundred and one patients with clinical and laboratory diagnosis of aseptic meningitis answered a questionnaire intended at assessing the severity and nature of headache and meningeal irritation signs before and one, and twenty four hours after the LP...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28178090/management-of-a-ventral-cerebrospinal-fluid-leak-with-a-lumbar-transforaminal-epidural-blood-patch-in-a-child-with-persistent-postdural-puncture-headache-a-case-report
#17
Genevieve Dʼsouza, F Glen Seidel, Elliot J Krane
OBJECTIVE: Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. CASE REPORT: An unusual case is described of an 11-year-old boy with PDPH, which was successfully managed with a ventral (anterior) epidural blood patch and epidural saline infusion after headache and other symptoms failed to resolve after conservative treatment and conventionally performed blood patches...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28107624/tocilizumab-alendronate-conjugate-for-treatment-of-rheumatoid-arthritis
#18
Hwiwon Lee, Suk Ho Bhang, Jeong Ho Lee, Hyemin Kim, Sei Kwang Hahn
An autoimmune disease of rheumatoid arthritis (RA) causes severe inflammation on the synovial membrane, which results in the destruction of articular cartilage and bone. Here, Tocilizumab (TCZ)-Alendronate (ALD) conjugate is synthesized for the early intervention of RA. A humanized monoclonal antibody of TCZ shows an immunosuppressive effect, targeting interleukin-6 (IL-6) receptor in the RA pathogenesis. ALD is an anti-inflammatory bisphosphonate drug which can bind to the exposed bone surface. ALD is conjugated selectively to N-glycan on Fc region of TCZ using a chemical linker of 3-(2-pyridyldithio)propionyl hydrazide (PDPH)-poly(ethylene glycol)-N-hydroxysuccinimide (PDPH-PEG-NHS)...
April 19, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/27910226/successful-treatment-of-postdural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#19
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of postdural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH. CASE REPORT: This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27843773/effect-of-position-during-spinal-anesthesia-on-postdural-puncture-headache-after-cesarean-section-a-prospective-single-blind-randomized-clinical-trial
#20
Maryam Davoudi, Masoud Tarbiat, Mohammad Reza Ebadian, Puran Hajian
BACKGROUND: The most common method of anesthesia for cesarean section is spinal anesthesia, and postdural puncture headache (PDPH) remains a major complication of this procedure. Nowadays, PDPH is a major cause of morbidity in parturients after spinal anesthesia. This headache is the third most popular reason for claims against anesthesiologists in obstetrics. The position after spinal anesthesia has been evaluated as a contributory factor in the occurrence of PDPH, but the position before spinal anesthesia has not yet been evaluated...
August 2016: Anesthesiology and Pain Medicine
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