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頁籤選單縮合
題名 | The Incidence of Post Dural Puncture Headache in Taiwanese Patients Undergoing Cesarean Section=臺灣剖腹產病人發生脊髓麻醉後頭痛之機率 |
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作者 | 黃忠章; 何善臺; 王志中; 郭文雄; 劉杭生; | 書刊名 | 麻醉學雜誌 |
卷期 | 35:1 1997.03[民86.03] |
頁次 | 頁1-6 |
分類號 | 417.372 |
關鍵詞 | 脊髓麻醉; 併發症; 頭痛; 硬脊膜穿刺; 產科手術; 剖腹產; Anesthesia:spinal; Postoperative complication:spinal puncture; Headache; Delivery:cesarean section; |
語文 | 英文(English) |
中文摘要 | 背景:目前臺灣有關剖腹產病人發生脊髓麻醉後頭痛之機率研究僅有一篇回顧報 告,但有關於硬脊膜穿刺針大小與脊髓麻醉後頭痛之機率關係則並未提到。因此設計了前瞻 性方式研究以了解剖腹產是否是脊髓麻醉後頭痛的一個重要因子以及使用較細之脊髓穿刺針 是否可以降低脊髓麻醉後頭痛之機率。 方法:使用前瞻性方式研究 2,385 個接受脊髓麻醉的病人,其中包括 584 個剖腹產病人。 每一病人隨機選擇 24 到 26 號脊髓穿刺針進行麻醉。術後持續觀察脊髓麻醉後頭痛直到消 失或一週內未發生此症狀。 結果:脊髓麻醉後頭痛之整體發生率是 1.18%。剖腹產病人發生率是 3.08%,統計上高於非 剖腹產女性之發生率 0.37%。 雖然女性的發生率 1.31% 統計高於男性 0.71%,但若以非剖 腹產女性來比較則統計上無差異。 24 到 26 號脊髓穿刺針對脊髓麻醉後頭痛之發生率無統 計上差異。 結果:脊髓麻醉後頭痛之發生率在臺灣與西方國家無差異。懷孕是產生脊髓麻醉後頭痛的一 個重要因子。 |
英文摘要 | Background:In Taiwan,there was only a retrospective study about the post-dural puncture headache (PDPH) resulting from spinal anesthesia for cesarean section (C/S),but it did not mention the relationship between the incidence of PDPH and the unmber of dural punctures, as well as between the gauge of spinal needle. There-fore, we designed a prospective study to investigate if the spinal needles of smaller gauges could decrease the incidence of PDPH in spinal anesthesia for C/S. Methods:From Jan. 1990 to June 1991 we prospectively observed 2,385 consecutive cases of spinal anes-thesia for various types of surgical procedures, of which 584 were C/S. The spinal needles used were of gauges 24, 25 and 26. In practice, needles of these gauges were randomly applied. The PDPH was observed until its disappearance, and nonexistence of PDPH was also followed for at least one week. All of the data were analyzed using the Fisher exact test. Results:The overall incidence of PDPH was 1.18%. The incidence of PDPH in C/S females was 3.08%,which was significantly highet than that in non-obstertric females(0.37%).Although the incidence in all females (1.31%) was significantly higher than that in males(0.71%), the incidence in non-obsteric females (0.37%)did not differ significantly compared with males. The incidence of PDPH relevant to the gauges of spinal needle used was not statistically different in C/S females. Conclusions:It appears that the incidence of PDPH does not differ between Taiwanese and Westerners. Pregnancy may be the key factor contributing to higher incidence of PDPH. The 26-gauge spinal needle may lower the incidence of PDPH to a greatestextent in C/S patients, although in comparison with 24-and 25-gauge needles the difference is not statistically significant. |
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