Skip to main content

Acute pain management Pearls...Part2... Post dural puncture Headache..



There is no evidence that bed rest is beneficial in the treatment and prevention of postdural puncture (Level 1 evidence (cochrane review))


The incidence of postdural puncture headache is reduced by using small-gauge spinal needles and/or a non-cutting bevel.level 1 evidence.

Further high quality trials are required to determine the efficacy of epidural blood patch administration in the treatment of postdural puncture headache (Level 1).However benefit is likely

Frequent use of analgesics, triptans and ergot derivatives in the treatment of recurrent acute headache may lead to medication overuse headache.

Labels:

Comments

  1. AnonymousMarch 21, 2012 at 7:24 AM

    very important topic thank you for posting it but I have some questions
    1- It seems there is something missing in the text...

    2-I could not understand could postdural puncture headache be recurrent or is it another subject please clarify.

    ReplyDelete
  2. BodyfitnessApril 28, 2013 at 8:09 AM

    I’m really impressed with your writing skills as well as with the layout on your blog. Is this a paid theme or did you modify it yourself? Anyway keep up the nice quality writing, it is rare to see a great blog like this one these days.
    http://bodyvibration.org

    ReplyDelete

Post a Comment

Popular posts from this blog

power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients     Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...
1 comment
Read more

Falling from Height...The Prognostic factors

Falls from Height is Knwon to cause major morbidities and mortalities.  There are several prognostic factors for survival that have been identified: Height Age Type of surface Body part that touches the ground first Two other factors are important, but do not have a significant effect on mortality: Circumstances of the fall (suicide, accident, escape) Initial impact with an object before impacting the ground Height . Overall, about half of victims die at the scene, and a total of 70% die before they reach the hospital . The median height leading to death is about 49 feet, or about 4 to 5 storeys. 100% of victims die after falling 85 feet, or about 8 storeys. Age . Mortality increases with age due to pre-existing medical conditions and decreased physiologic reserve. Type of surface . The type of surface struck (i.e. grass, water, construction debris) can also have an effect on secondary injuries and survival. Mortality after striking a hard surface is nearly doubl...
Post a Comment
Read more

The 12 decision making steps for post dural puncture headache treatment

Treatment decision-making algorithm for postdural puncture headache. 1. When diagnosis is made, all patients should receive supportive measures (reassurance, bed rest, analgesics, hydration, quiet environment). 2. Severity of symptoms should be classified using VAS scale (mild 1–3, moderate 4–6, severe 7–10). 3. Virtually all patients will improve in time even without additional therapy. (dashed lines) 4. Symptoms worsen or fail to resolve within 5 days. 5. Patient preference dictates the choice between pharmacologic (less effective) and epidural blood patch (EBP). 6. In patients with severe symptoms, EBP is strongly suggested. 7. The most common pharmacologic measure is  caffeine  prescription. 8. The failure, worsening, or recurrence of symptoms after pharmacologic measures favors the use of EBP. 9. In addition to EBP, other epidural treatment options can be considered in select patients (eg,  dextran , saline). 10. A period of 24 h should lapse before repeating EBP. 11...
1 comment
Read more