UNASSIGNED: Postdural puncture headache (PDPH) is a common consequence of cesarean section surgeries after spinal anesthesia. This case study describes the successful treatment of PDPH with intravenous neostigmine and atropine. A 31 years female who underwent elective cesarean section with spinal anesthesia developed a severe headache on the 6th postoperative day and was diagnosed to have PDPH. PDPH failed to respond to conventional treatment modalities like hydration, a Non-steroidal anti-inflammatory drug, and sphenopalatine ganglion block. Epidural blood patch could not be performed due to lack of consent. A trial dose of intravenous neostigmine (20 mcg/kg) along with atropine (10 mcg/kg) successfully provided symptomatic and clinical relief. The combination of neostigmine and atropine demonstrates a rapid onset of action, providing patients with effective analgesia while avoiding the need for invasive procedures such as epidural blood patches and offers quicker pain relief. This promising result warrants additional research.
■硬膜穿刺后头痛(PDPH)是脊柱麻醉后剖宫产手术的常见后果。此案例研究描述了静脉注射新斯的明和阿托品成功治疗PDPH。一名31岁的女性在脊髓麻醉下进行了选择性剖宫产手术,在术后第6天出现了严重的头痛,并被诊断为患有PDPH。PDPH对水合等常规治疗方式没有反应,非甾体抗炎药,和蝶腭神经节阻滞。由于缺乏同意,无法进行硬膜外补血。静脉注射新斯的明(20mcg/kg)和阿托品(10mcg/kg)的试验剂量成功地提供了症状和临床缓解。新斯的明和阿托品的组合显示出快速起效,为患者提供有效的镇痛,同时避免需要侵入性程序,如硬膜外血贴片,并提供更快的疼痛缓解。这个有希望的结果值得进一步研究。