4
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Experiencia clínica con la implantación de un protocolo multidisciplinar de cefalea postpunción dural Translated title: Clinical experience with the implementation of a postdural puncture headache multidisciplinary protocol

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          RESUMEN Introducción: La cefalea postpunción dural (CPPD) es una complicación de la punción lumbar, práctica utilizada por múltiples especialistas con diferentes fines, y de la punción dural accidental (PDA) en una técnica epidural. El objetivo de disponer de un protocolo de manejo de la CPPD, con implicación multidisciplinar, es diagnosticar y tratar precozmente a cualquier paciente con CPPD, independientemente de qué especialidad observe la complicación. Material y métodos: Estudio descriptivo, observacional y retrospectivo en el que se analiza la utilidad clínica de un protocolo de manejo de CPPD entre septiembre de 2014 y diciembre de 2017. Resultados: Se analizaron un total de 60 interconsultas. Se observó una incidencia de PDA del 0,61 %, el 80 % de las PDA desarrollaron CPPD, y de ellas, el 72 % precisó un parche hemático. Con el seguimiento telefónico, 8 pacientes que inicialmente fueron dados de alta con CPPD leve precisaron reingreso por empeoramiento clínico, y se diagnosticó un paciente con parálisis del VI par craneal. Los especialistas que incluyeron pacientes en el protocolo fueron: anestesiólogos, obstetras, médicos de urgencias y neurólogos. Conclusiones: El protocolo permitió un diagnóstico y tratamiento precoz de la CPPD, además de un seguimiento tras el alta hospitalaria del paciente.

          Translated abstract

          ABSTRACT Introduction: Postdural puncture headache (PDPH) is a lumbar puncture complication, this practice is used by several medical specialists for different purposes as well as the accidental dural puncture (ADP) in an epidural technique. The objective of a PDPH multidisciplinary management protocol, is to diagnose and early treat any patient with PDPH, no matter which speciality observes this complication. Material and methods: A descriptive, observational and retrospective study in which the clinical helpfulness of a PDPH management protocol is analyzed between September 2014 and December 2017. Results: A total of 60 consult visits were analyzed. An incidence of ADP of 0.61 % was observed, 80 % of them developed PDPH, and out of these, 72 % required an epidural blood patching. Re-entry due to clinical worsening was required by 8 patients on telephone follow-up, who were initially discharged with mild PDPH, and one of them was diagnosed with abducens nerve palsy. Medical specialities with patients in this protocol were: anesthesiologists, obstetricians, emergency physicians and neurologists. Conclusions: The protocol allowed a diagnosis and early treatment of the PDPH as well as supplied the patient's follow-up after his hospital discharge.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: not found
          • Article: not found

          The International Classification of Headache Disorders, 3rd edition

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Postdural puncture headache

            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. An epidural blood patch is the most effective treatment option for patients with unsuccessful conservative management. Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Posture and fluids for preventing post-dural puncture headache

              Post-dural puncture headache (PDPH) is a common complication of lumbar punctures. Several theories have identified the leakage of cerebrospinal fluid (CSF) through the hole in the dura as a cause of this side effect. It is therefore necessary to take preventive measures to avoid this complication. Prolonged bed rest has been used to treat PDPH once it has started, but it is unknown whether prolonged bed rest can also be used to prevent it. Similarly, the value of administering fluids additional to those of normal dietary intake to restore the loss of CSF produced by the puncture is unknown. This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 7, 2013) on "Posture and fluids for preventing post-dural puncture headache".
                Bookmark

                Author and article information

                Journal
                dolor
                Revista de la Sociedad Española del Dolor
                Rev. Soc. Esp. Dolor
                Inspira Network Group, S.L (Madrid, Madrid, Spain )
                1134-8046
                April 2020
                : 27
                : 2
                : 133-137
                Affiliations
                [1] Santa Cruz de Tenerife orgnameHospital Universitario Nuestra Señora de Candelaria orgdiv1Servicio de Anestesiología y Reanimación España
                Article
                S1134-80462020000200133 S1134-8046(20)02700200133
                10.20986/resed.2020.3782/2019
                aa5862af-b567-434b-ac2f-c9260da8fd9f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 13 January 2020
                : 09 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 5
                Product

                SciELO Spain

                Categories
                Notas Clínicas

                protocol,Postdural puncture headache,protocolo,parche hemático epidural,epidural blood patch,accidental dural puncture,Cefalea pospunción dural,lumbar puncture,punción dural accidental,punción lumbar

                Comments

                Comment on this article