Post spinal headache Its incidence following the median and paramedian techniques


     Related Videos

     Related Hubpages

  •  Doc. Url:    Embed Code: 

  • PubMed  status
    (0) (0 Votes)
    Views: (1083)   Date: (13-03-09)   Pages: ()
  • Author:  [Article in German]  

  • Abstract:  [Post spinal headache. Its incidence following the median and paramedian techniques] [Articl e in German] Janik R, Dick W. Klinik f?r Anaesthesiologie, Johannes Gutenberg-Universit? t Mainz. A lack of uniform methodology used by different authors in the assessment of different puncture techniques in spinal anesthesia formed the basis of the current study, which compared under randomized conditions the incidence of post spinal headache after a median or paramedian (lateral) approach. MATERIALS AND METHODS. Two hundred and fifty ASA physical status II and III patients, aged 50-85 years, scheduled for transurethral prostate surgery under spinal anesthesia were investigated. The patients were comparable with regard to weight and height (Table 1). No premedication was given and, 30 min prior to surgery, all patients received normal saline 400-500 ml i.v. The patients were randomly divided into two groups of 125 patients each to receive 4 ml 0.5% bupivacaine in 5% glucose (specific gravity 1.017 at 20 degrees C) using the median or paramedian (lateral) approach according to the following scheme (Table 2): I: 4 ml 0.5% bupivacaine/median approach; II: 4 ml 0.5% bupivacaine/paramedi an approach. The study was carried out in a double-blind fashion. Neither the patient nor the investigator evaluating the post spinal headache was aware of which technique had been used. Lumbar puncture was performed by a midline approach at the L3-4 interspace using a 25-gauge (Whitacre) spinal needle with the patient in the sitting position group I. The bevel of the spinal needle was directly laterally, so that the dural fibers that run longitudinally were spread rather than transected. When using the paramedian approach (group II), patients were placed in the flexed lateral decubitus position and the spinal needle inserted 1 cm medial and 1 cm lateral and caudad to the lowest part of the posterior superior iliac spine and then directed medially and cephalad at an angle of 55 degrees into the subarachnoid space. Postoperatively, patients were allowed to move as soon as possible; no prophylactic bed rest was ordered. Starting from the 1st postoperative day, patients were evaluated by an independent observer and asked whether they were suffering from any problems concerning anesthesia. Typical post-puncture headache was defined as invariably bifrontal and occipital, frequently involving the neck and upper shoulders, and being aggravated by the upright position. Statistical analysis of the data was performed using the Mann-Whitney rank-sum test for unpaired samples. A P value of less than 0.05 was considered statistically significant. RESULTS. Twenty-six of 250 patients (10.4%) developed post spinal headaches. Comparing both groups, 11/125 (8.8%) patients in the median group (group I) versus 15/125 (12%) in the paramedian group (group II) had typical post-puncture headaches. Within the group of patients aged 50-60 years, the paramedian approach (group II) showed a significantly higher headache rate compared with group I (P less than 0.05). Neurologic sequelae were not observed; 6 patients received epidural injections of autologous blood while the rest of the patients suffering from post spinal headache were treated conservatively with bed rest, analgesics, and fluids. CONCLUSIONS. The results indicate that the incidence of post spinal headache is higher in younger patients when using the paramedian (lateral) approach. However, our findings suggest that the choice of lumbar puncture technique--median or paramedian--is of little importance in regard to post-puncture headache in elderly patients. The paramedian approach is especially useful when degenerative changes are encountered in the interspinous structures in elderly patients, when an ideal position is difficult to achieve. PMID: 1570886 [PubMed - indexed for MEDLINE]

     Related Documents

         Related Groups

         Related Science News

           More on Sciencestage

           Answers

             News

               Related on Youtube Results
        • Взводные покатушки в группе Raidcall 777
          Взводные покатушки в группе Raidcall 777 From: Александр Илюшин Views: 0 11 ratings Time: 01:28:17 More in Gaming
        • RBL BFCL Cup #6 - Rubicon vs RSA - Battlefield 4
          RBL BFCL Cup #6 - Rubicon vs RSA - Battlefield 4 Чемпионат RBL BFCL Cup #6. Группа AB - 21.10.2014; начало в 21:00 по МСК Команды - [Rubi] Rubicon vs [RSA] Red Star Alliance Карты - Плотина на... From: VVARning Schemov Views: 21 419 ratings Time: 02:00:17 More in Gaming
        • PODkedd E67 -
          PODkedd E67 - Email címem: thecoveryhu@gmail.com Weboldal: http://justgamers.hu/video-lista/TheCovery Twitter: http://twitter.com/gcsomesz Facebook: http://facebook.hu/YT.Covery. From: TheCovery Views: 2 336 ratings Time: 01:52:12 More in Gaming
        • DIRECTO || LSMADLH 2 - LA MITAD - Episodio 100 de 200
          DIRECTO || LSMADLH 2 - LA MITAD - Episodio 100 de 200 SÍGUEME EN TWITTER Y FACEBOOK y preguntame lo que quieras! TWITTER: https://twitter.com/EvilAFM FACEBOOK: https://www.facebook.com/AlexelcapoOficial Intento responder tantas preguntas ... From: alexelcapo Views: 0 9644 ratings Time: 54:52 More in Gaming
        • FIFA 15 | SOBRES DE 15.000 MONEDAS | BUSCANDO A OKOCHA
          FIFA 15 | SOBRES DE 15.000 MONEDAS | BUSCANDO A OKOCHA Fifacheap: http://www.fifacheap.com/?refuid=232004 Codigo: cacho Compra tus juegos y tarjetas mas baratos: https://www.g2a.com/r/insanefifa --------------------------------- - Sígueme en Twitter... From: Cacho01 Views: 54 486 ratings Time: 27:03 More in Gaming
        • WR Buried +107 Bartoloyanga&Xarli23tv
          WR Buried +107 Bartoloyanga&Xarli23tv https://www.youtube.com/user/Xarli23tv Suscribete :) : http://goo.gl/1xESKM Y tu like como es? Verde o azul? Compruebalo!!! xD Sigueme en google+: https://plus.google.com/+bartoloyanga/posts... From: bartoloyanga Views: 1 191 ratings Time: 02:24:58 More in Gaming
        • دور الإعلام التونسي في مرحلة التحول الديمقراطي
          دور الإعلام التونسي في مرحلة التحول الديمقراطي دور الإعلام التونسي في مرحلة التحول الديمقراطي تقرير الواقع العربي تقديم: عبد القادر عراضة تاريخ البث: 21/10/2014. From: Al Jazeera Arabic Views: 0 0 ratings Time: 03:37 More in News & Politics
        • Прямая Трансляция 21-10-2014
          Прямая Трансляция 21-10-2014 Подписывайся на паблик красочных боёв! http://vk.com/public50677967. Только тут ты сможешь увидеть бои мастеров вормикса... From: Eduard Maracineanu Views: 0 53 ratings Time: 01:47:43 More in Gaming
        • Суровое выживание в The Long Dark
          Суровое выживание в The Long Dark Купить игры со скидкой можно тут - http://plaaay.ru Купон на скидку в 5%: POMIDORKA-DSM. Старые... From: PomodorkaZR Views: 225 676 ratings Time: 01:34:22 More in Gaming
        • Waarom varen boten nog steeds tegen bruggen aan? (2/5)
          Waarom varen boten nog steeds tegen bruggen aan? (2/5) Het zal je als schipper maar gebeuren: met je schip vast komen te zitten onder een brug, omdat je de hoogte verkeerd hebt ingeschat. Hoe vaak moet je een meting uitvoeren voor je min of meer... From: Universiteit van Nederland Views: 3 0 ratings Time: 15:01 More in Education
        • Арыстан - Арлан (21.10.2014)
          Арыстан - Арлан (21.10.2014) From: Арыстан Темиртау Views: 149 0 ratings Time: 02:19:09 More in Sports
        • BEST NIDALEE EUW??? TAMPOCO FLIPEIS ^^
          BEST NIDALEE EUW??? TAMPOCO FLIPEIS ^^ Like y deja vivir Leelo wey!! Vamos a ver si damos cañita con nidalee mid, que me encanta este campeon Un saludo y espero que os guste! ------------------------------------------------------------... From: galera41 Views: 0 93 ratings Time: 01:41:56 More in Gaming
        • مكفوفون بموريتانيا يؤسسون فرقة موسيقية
          مكفوفون بموريتانيا يؤسسون فرقة موسيقية أنشأت مجموعة من المكفوفين الموريتانيين -بعضهم كان يمتهن التسول- فرقة موسيقية. وتسعى المجموعة إلى تغيير نظرة... From: Al Jazeera Arabic Views: 0 0 ratings Time: 02:14 More in News & Politics
        • Артём Решетило! Прямая трансляция 21.10.14
          Артём Решетило! Прямая трансляция 21.10.14 Если любишь Wormix, подпишись на наш канал! Группа ВКонтакте - http://vk.com/wormix_new Артём Решетило - http://vk.com/warmix У нас... From: Канал игры Вормикс Views: 0 47 ratings Time: 01:50:26 More in Gaming
        • Live #38 | Obosit...
          Live #38 | Obosit... Salut și bine te-am regăsit la un nou video pe canalul meu :3 Dacă îți place ceea ce fac nu uita să te abonezi! ••••••••••••••••••••••••... From: Trex Views: 0 83 ratings Time: 00:00 More in Gaming
        • مراسلو الجزيرة- أسكتلندا ثقافيا.. والخط العربي بريشة فنان ياباني
          مراسلو الجزيرة- أسكتلندا ثقافيا.. والخط العربي بريشة فنان ياباني مراسلو الجزيرة- أسكتلندا ثقافيا.. والخط العربي بريشة فنان ياباني تاريخ البث: 21/10/2014. From: Al Jazeera Arabic Views: 1 1 ratings Time: 22:24 More in News & Politics
        • رأي سكان ريف اللاذقية في ضربات التحالف الدولي
          رأي سكان ريف اللاذقية في ضربات التحالف الدولي تواجه الضربات التي يشنها التحالف الدولي ضد تنظيم الدولة الإسلامية رفض أغلب السوريين بالمناطق المستهدفة.... From: Al Jazeera Arabic Views: 1 0 ratings Time: 01:57 More in News & Politics
        • Computer Science 170 - 2014-10-20
          Computer Science 170 - 2014-10-20 Computer Science 170, 001 - Fall 2014 Efficient Algorithms and Intractable Problems - David Wagner All rights reserved. From: UCBerkeley Views: 0 0 ratings Time: 51:52 More in Education
        • Daddy Warpig's Kick-Ass Geek Cast, Episode 4
          Daddy Warpig's Kick-Ass Geek Cast, Episode 4 The Big Bad Blogger is Back! 30 minutes of high-energy, fast-paced, kick-ass geek-ocentric commentary from the Alpha Geek himself, Daddy Warpig! blog: daddywarpig.wordpress.com Twitter: ... From: Daddy Warpig Views: 0 0 ratings Time: 00:00 More in Gaming
        • Leafs hire Mark Hunter, is brother Dale next?
          Leafs hire Mark Hunter, is brother Dale next? Hockey Central at Noon discussion on the news that the Leafs have hired London Knights GM Mark Hunter as their new director of player personnel, which leads to speculation that Dale Hunter... From: SPORTSNETCANADA Views: 0 0 ratings Time: 04:33 More in Sports
        • LIVESTREAM! ► Salt, Ancient Tomb!
          LIVESTREAM! ► Salt, Ancient Tomb! Don't forget to LIKE, COMMENT and SUBSCRIBE Follow me on my other sites and come hang out! ☆ Teamspeak ▻ http://tiny.cc/BluedrakesTeamspeak My Twitter ▻ https://twitter.com/Blued... From: Bluedrake42 Views: 0 32 ratings Time: 00:00 More in Gaming
        • صالح من بين معرقلي العملية الانتقالية في اليمن
          صالح من بين معرقلي العملية الانتقالية في اليمن أفاد مراسل الجزيرة في نيويورك بأن فريق الخبراء التابع للجنة العقوبات الخاصة باليمن حدد أسماء خمسة وصفهم... From: Al Jazeera Arabic Views: 3 2 ratings Time: 02:04 More in News & Politics
        • The Evil Within #6 - Platform32 Let's Play LIVE
          The Evil Within #6 - Platform32 Let's Play LIVE The Evil Within #6 - Platform32 Let's Play LIVE WARNING SPOILERS! Last time on The Evil Within, barbed wire cover cage head man caused Ian some hassles in a fart filled room. In this episode... From: Platform32 Views: 0 16 ratings Time: 00:00 More in Gaming
        • AS Roma - Bayern Munich Preview & USWNT Win 6-0: Soccer Morning
          AS Roma - Bayern Munich Preview & USWNT Win 6-0: Soccer Morning Welcome to today's episode of Soccer Morning with Jason Davis on Soccerly. Jason kicks off today's show with David Amoyal as they look back at the weekend's Serie A headlines & preview AS... From: Soccerly Views: 0 5 ratings Time: 01:24:48 More in Sports
        • League of Legends - Livestream #2
          League of Legends - Livestream #2 CO MUSÍTE UDĚLAT ABYSTE SI SE MNOU ZAHRÁLI? Vytvořte si nový účet. Žádný strach. Není to proti pravidlům Riotu. Použijte tento odkaz: http://signup.leagueoflegends.com/?ref=4d4aa0423e... From: Sterakdary Views: 0 0 ratings Time: 00:00 More in Gaming

        •      Related on Wikipedia




























           

          Powered free by PHPmotion