■在产科人群中,脊髓麻醉后硬膜穿刺后头痛(PDPH)的发生率约为0.5%-2%。水化,卧床休息,咖啡因,扑热息痛,非甾体抗炎药,硬膜外血片,等。,是用于其管理的各种模式。本研究旨在比较右美托咪定与芬太尼雾化吸入治疗腰麻剖宫产术后产妇PDPH的效果。
■这项双盲随机研究招募了90名年龄在18-35岁的产科患者,其美国麻醉医师协会(ASA)的身体状况为II/III,并且根据国际头痛协会的标准患有PDPH。患者随机分为D组(右美托咪定1µg/kg雾化吸入),F组(芬太尼1µg/kg雾化),和S组(盐水雾化4mL)。雾化每12小时进行72小时。评估参数包括疼痛评分和额外治疗的要求,如扑热息痛,咖啡因,和硬膜外血贴.连续定量变量采用方差分析检验,并将Kruskal-Wallis检验用于定量离散数据。
雾化吸入后1、6、12、24、48和72小时的疼痛评分在D组中显著低于F和S组(P<0.001)。与其他组相比,D组需要额外镇痛治疗的患者人数较少(P<0.001)。
■右美托咪定雾化吸入可有效降低PDPH症状和疼痛评分。与对照组相比,芬太尼雾化吸入不能缓解PDPH症状。
UNASSIGNED: The incidence of post-dural puncture headache (PDPH) following spinal anaesthesia in the obstetric population is around 0.5%-2%. Hydration, bed rest, caffeine, paracetamol, non-steroid anti-inflammatory drugs, epidural blood patches, etc., are the various modalities used for its management. This study aims to compare nebulised dexmedetomidine versus fentanyl for the treatment of PDPH in parturients after caesarean section under spinal anaesthesia.
UNASSIGNED: Ninety obstetric patients aged 18-35 years with American Society of Anesthesiologists (ASA) physical status II/III and suffering from PDPH as per the criteria of the International Headache Society after caesarean section under spinal anaesthesia were recruited in this double-blinded randomised study. Patients were randomised to Group D (dexmedetomidine 1 µg/kg nebulisation), Group F (fentanyl 1 µg/kg nebulisation), and Group S (saline nebulisation 4mL). The nebulisation was done 12 hourly for 72 hours. Assessment parameters included pain score and the requirement of additional treatment such as paracetamol, caffeine, and epidural blood patch. Analysis of variance test was used for continuous quantitative variables, and the Kruskal-Wallis test was used for quantitative discrete data.
UNASSIGNED: The pain scores at 1, 6, 12, 24, 48, and 72 hours following nebulisation were significantly lower in Group D in comparison to groups F and S (P < 0.001). The number of patients requiring additional analgesic therapy was lower in Group D in comparison to patients in other groups (P < 0.001).
UNASSIGNED: Dexmedetomidine nebulisation resulted in effective reduction in PDPH symptoms and pain scores. Nebulisation with fentanyl did not alleviate PDPH symptoms when compared to the control group.