Insertion of an intrathecal catheter following accidental dural puncture
| Autor: | Rolf Rossaint, M. Van de Velde, Sebastian Straube, S. Klöhr, M.A. Walters, M. Heesen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Anesthesia
Epidural medicine.medical_specialty Catheters Tuohy needle Postdural puncture headache Spinal Puncture Catheterization MORPHINE 03 medical and health sciences 0302 clinical medicine HEADACHE 030202 anesthesiology Pregnancy TUOHY NEEDLE medicine Odds Ratio MANAGEMENT Anesthesia Obstetrical Humans 030212 general & internal medicine EPIDURAL ANALGESIA LABOR PARTURIENTS Epidural blood patch RISK Catheter insertion Medical Errors OBSTETRIC PATIENTS business.industry Intrathecal catheters Obstetrics and Gynecology Odds ratio Accidental dural puncture 3. Good health Surgery Catheter Anesthesiology and Pain Medicine Anesthesia Relative risk Meta-analysis Female Dura Mater Post-Dural Puncture Headache Complication business Blood Patch Epidural |
| Zdroj: | International journal of obstetric anesthesia. 22(1):26-30 |
| ISSN: | 0959-289X |
| Popis: | Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A systematic literature search was performed, paralleled by a hand search of abstract publications. Studies that reported. the dichotomous outcome parameters postdural puncture headache or need for an epidural blood patch were considered eligible. Risk ratios with 95% confidence intervals were calculated. Results: We identified nine reports investigating placement of intrathecal catheters after accidental dural puncture. The risk ratio for an epidural blood patch after intrathecal catheter insertion was 0.64 (95% CI 0.49-0.84, P = 0.001). The risk ratio for postdural puncture headache was 0.82 (95% CI 0.67-1.01, P = 0.06). Discussion: Inserting an intrathecal catheter significantly reduced the risk for an epidural blood patch; the incidence of postdural puncture headache was reduced but not significantly. Accidental dural puncture is a rare complication and therefore trials on intervention need to include a large number of patients which is time-consuming and costly. Intrathecal catheterisation is a promising approach for the prevention of postdural puncture headache and should be evaluated further. This intervention has additional benefits including a reduced risk of repeat dural puncture, rapid onset of action and use for anaesthesia. (C) 2012 Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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