Post spinal headache Its incidence following the median and paramedian techniques


     Related Videos
America as Post-Racial or Post-Racist? - Michael Eric Dyson
America as Post-Racial or Post-Racist? - Michael Eric Dyson
xStop Spinal Procedure
  • xStop Spinal Procedure

  • A minimally invasive procedure to help with back and leg pain. ... spine surgery back leg pain ortho...

Spinal Disorder Arab
  • Spinal Disorder Arab

  • including the causes and diagnosis of degenerative spinal disorders like prolapsed disc. WARNING: SO...

Stefan A Mindea MD on Spinal Disorders

     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
          • I'M THE REAL ZEUS, B!#T¤! // PLAYING SMITE WITH BROS!
            I'M THE REAL ZEUS, B!#T¤! // PLAYING SMITE WITH BROS! Check Out: http://www.hirezstudios.com/esports For Brofist Logo: http://bit.ly/1A1lixc Get Smite: www.smitegame.com More Smite ▻ https://www.youtube.com/watch?v=6q0uAevwQ2Q Click Here... From: PewDiePie Views: 99 31 ratings Time: 05:56 More in Gaming
          • War Tourism in the Golan Heights: The War Next Door (Part 3)
            War Tourism in the Golan Heights: The War Next Door (Part 3) Watch Part 1 - http://bit.ly/1AuJhp5 Watch Part 2 - http://bit.ly/1C3kXyE In August, al Nusra Front jihadists took control of Syria's side of the border crossing with Israel and kidnapped... From: VICE News Views: 301 23 ratings Time: 08:16 More in News & Politics
          • GTA 5 Christmas DLC Online - Zombie Survival Challenges & More Gameplay (GTA V Gameplay)
            GTA 5 Christmas DLC Online - Zombie Survival Challenges & More Gameplay (GTA V Gameplay) GTA 5 Christmas DLC GTA 5 Online - GTA 5 Christmas DLC Zombie Survival GTA 5 Online Challanges (GTA V Gameplay) GTA 5 Online & GTA 5 Gameplay Enjoyed the video? Subscribe: ... From: TwoDynamic Views: 0 295 ratings Time: 00:00 More in Gaming
          • Vadjacent?!
            Vadjacent?! Home Decor Haul: http://bit.ly/13esQSS ✿ The day Liam was born: http://goo.gl/niJZ2i ✿ Please like + subscribe: http://goo.gl/q1EwWz ✿ Shop our store Saturday Sunshine: http://goo.gl/qrqTy5... From: AprilJustinTV Views: 301 661 ratings Time: 13:45 More in People & Blogs
          • GTA 5 Online Christmas DLC - Zombie Survival GTA Online Challenges! - (GTA V Gameplay)
            GTA 5 Online Christmas DLC - Zombie Survival GTA Online Challenges! - (GTA V Gameplay) GTA 5 Christmas GTA 5 DLC - Zombie GTA Online GTA 5 Challanges! (GTA V Gameplay) GTA 5 Online & GTA 5 Gameplay! Enjoyed the video? Subscribe: http://goo.gl/db1vMQ ▻ Follow Me On ... From: iCrazyTeddy Views: 0 956 ratings Time: 00:00 More in Gaming
          • Peshawar prie pour les victimes de l'attaque des talibans
            Peshawar prie pour les victimes de l'attaque des talibans Une ville en deuil rend hommage lors de la prière du vendredi aux victimes de l'attaque des talibans contre une école de Peshawar, la plus meurtrière de l'histoire du pays. Durée: 01:16. From: AFP Views: 15 0 ratings Time: 01:16 More in Education
          • დიპლომატიური ვიქენდი - ევროპული არჩევანი
            დიპლომატიური ვიქენდი - ევროპული არჩევანი From: freeunimedia Views: 1 0 ratings Time: 02:34:18 More in Education
          • Au Morning Gloryville, les clubbers londoniens font la fête le matin
            Au Morning Gloryville, les clubbers londoniens font la fête le matin Plutôt que de monter les basses pendant la nuit, le Morning Gloryville, nouveau phénomène du clubbing dans la capitale anglaise, fait vibrer les enceintes tôt le matin. L'événement n'a... From: AFP Views: 0 0 ratings Time: 01:36 More in Howto & Style
          • Visite de Manuel Valls à Rennes
            Visite de Manuel Valls à Rennes Le Premier ministre Manuel Valls était à Rennes vendredi 19 décembre pour la signature du décret de création de la métropole. Durée: 00:57. From: AFP Views: 28 1 ratings Time: 00:58 More in News & Politics
          • I WAS ON SOUTH PARK!
            I WAS ON SOUTH PARK! Thanks to you bros! Watch the full episode here: http://www.southparkstudios.co.uk/ Click Here To Subscribe! ▻ http://bit.ly/JoinBroArmy Comments Here! ▻ http://bit.ly/BroComments ... From: PewDiePie Views: 301 46923 ratings Time: 03:13 More in Gaming
          • "Avtobaz" -Istanbul 2015 yarışmasında FİNAL
            "Avtobaz" -Istanbul 2015 yarışmasında FİNAL Bu gün Dekabrın 31-i İstanbula gedəcək iştirakçının adı bəlli olacaq. Arzu Həsənli Tural Rustəmliyə qarşı.Saat 17:00-dan etibarən izləyə bilərsiniz. From: Tural Yusifov Views: 3 3 ratings Time: 44:43 More in Autos & Vehicles
          • 【コスケのパズドラお悩み相談教室】第56回
            【コスケのパズドラお悩み相談教室】第56回 チャンネル登録をよろしくお願いします http://bit.ly/18ogRmf ※BGMが無かったため再アップいたしました。大変申し訳ございません。 ▽質問一覧... From: コスケのパズドラ究極攻略TV Views: 301 216 ratings Time: 12:04 More in Entertainment
          • [Стрим] Stronghold Crusader 2 - 19.12.14
            [Стрим] Stronghold Crusader 2 - 19.12.14 Канал: http://youtube.com/ToBaPu4CaHeK Вконтакте: http://vk.com/ToBaPu4CaHeK Твиттер: https://twitter.com/ToBaPu4 Стримы: http://twitch.tv/ToBaPu4. From: ToBaPu4_CaHeK Views: 0 21 ratings Time: 01:49:40 More in Gaming
          • 20141219-2 黑豹旗高中棒球 高苑工商vs桃園農工
            20141219-2 黑豹旗高中棒球 高苑工商vs桃園農工 From: vlsports Views: 8001 78 ratings Time: 03:35:58 More in Sports
          • VICE News Daily: Beyond The Headlines - December 19, 2014
            VICE News Daily: Beyond The Headlines - December 19, 2014 Subscribe to VICE News here: http://bit.ly/Subscribe-to-VICE-News The VICE News Capsule is a news roundup that looks beyond the headlines. Today: Kenyan lawmakers approve controversial ... From: VICE News Views: 536 246 ratings Time: 03:04 More in News & Politics
          • 11 familles roms relogées dans une ancienne gendarmerie
            11 familles roms relogées dans une ancienne gendarmerie Onze familles roms, sur une centaine que compte le bidonville d'Ivry-sur-Seine (Val-de-Marne), ont été relogées jeudi 18 décembre dans une ancienne gendarmerie de la commune. Ces familles... From: AFP Views: 14 0 ratings Time: 01:29 More in News & Politics
          • VLOG Моя повседневная жизнь (мой сложный ЧЕТВЕРГ, съемки)
            VLOG Моя повседневная жизнь (мой сложный ЧЕТВЕРГ, съемки) www.allabout.me https://vk.com/8allaboutme. Канал Димы: https://www.youtube.com/user/dmitrykrikun. ♔ИНСТАГРАМ: http://instagram.com/... From: Julia Pushman Views: 301 6001 ratings Time: 17:33 More in Film & Animation
          • «Смилодон» (Москва) — Сборная Московской области
            «Смилодон» (Москва) — Сборная Московской области Кубок России по хоккею с мячом среди женских команд. From: Спортивный клуб «Обухово» Views: 1 1 ratings Time: 02:04:34 More in Sports
          • 20141219-1 SBL超級籃球聯賽 金酒vs台啤
            20141219-1 SBL超級籃球聯賽 金酒vs台啤 From: vlsports Views: 9 14 ratings Time: 02:00:24 More in Sports
          • Un vieux Disney qu'on croyait perdu refait surface en Norvège
            Un vieux Disney qu'on croyait perdu refait surface en Norvège Un vieux film d'animation de Walt Disney que l'on croyait perdu a refait surface dans le Grand Nord de la Norvège, a annoncé jeudi la Bibliothèque nationale norvégienne. Durée: 01:00. From: AFP Views: 1 0 ratings Time: 01:00 More in News & Politics
          • Ebola:des motocyclistes pour répandre les messages de prévention
            Ebola:des motocyclistes pour répandre les messages de prévention Plus de 6.900 personnes sont mortes du virus Ebola, la plupart d'entre elles en Afrique de l'Ouest, a annoncé mercredi l'Organisation mondiale de la Santé à Genève. En Sierra Leone, des... From: AFP Views: 18 1 ratings Time: 00:58 More in News & Politics
          • Gunz2 มาคนเดียวก็เปรี้ยวได้ สัปดาห์ที่ 3 วันที่ 19/12/57
            Gunz2 มาคนเดียวก็เปรี้ยวได้ สัปดาห์ที่ 3 วันที่ 19/12/57 สามารถติดตามถ่ายทอดสดได้ที่ www.tgpl.in.th หรือติดตามข่าวสารที่ https://www.facebook.com/TGPLtv... From: CompgamerTV Views: 1 0 ratings Time: 52:30 More in Gaming
          • Tình Đầu Khó Phai Phần 2 Tập 158 + Tập 159
            Tình Đầu Khó Phai Phần 2 Tập 158 + Tập 159 Bạn đang xem bộ phim Tình Đầu Khó Phai phát sóng vào 17h30 hàng ngày. Chúc các bạn xem phim vui vẻ. Tình Đầu Khó Phai tập 158, tinh dau kho phai tap 158, Tình Đầu... From: Deezay May Views: 52 0 ratings Time: 59:55 More in Entertainment
          • Vòng Xoáy Kim Tiền Tập 252 - (DN1: 250 ngày 19-12-2014)
            Vòng Xoáy Kim Tiền Tập 252 - (DN1: 250 ngày 19-12-2014) Vòng Xoáy Kim Tiền Tập 252, Phim Đài Loan, Vòng Xoáy Kim Tiền 252, vong xoay kim tien tap 250 DN1, Xem phim vòng xoáy kim tiền tập 250, vong xoay kim tien 251 252 253. Vòng... From: Cùng Xem Phim Views: 487 2 ratings Time: 51:55 More in Gaming
          • SECOND SEGMENT OF TODAY´S FASTING AND PRAYER
            SECOND SEGMENT OF TODAY´S FASTING AND PRAYER From: Apostle Emmanuel Obazele Views: 0 0 ratings Time: 02:20:41 More in Entertainment

          •      Related on Wikipedia




























             

            Powered free by PHPmotion