Abstract:
BACKGROUND:Post-dural puncture headache (PDPH) is the most common complication of procedures in which the dura mater is penetrated. OBJECTIVES:To evaluate the effectiveness of caudal saline injections as a therapeutic approach for handling post-dural puncture headache. STUDY DESIGN:Prospective observational study between 1995 and 2010. SETTING:Associated teaching hospital. METHODS:A 5-cm 20-gauge short-beveled needle, connected by extension tube to a 20-mL syringe filled with normal saline was used for injection. During injection in increments (limited by patient discomfort), the patients were asked continually to quantify their pain experience on a visual analog scale (VAS) and on a 0-3 verbal categorical rating scale (VRS) after 50, 80 and 100 mL of infusion over a 20 minute period. LIMITATIONS:This study is limited by its sample size, observational design, and lack of long-term outcomes. RESULTS:PDPH occurred in 60 of 1,716 patients undergoing dural puncture (3.5%). It was significantly more common in women and occurred more often in young adults. The rate was highest in the spinal catheter group (13%) and lowest in the Sprotte needle group (0.98%). Fifty-six patients underwent caudal saline injections which were repeated in sessions of 1-2 times a day for 1-2 days. Most patients (n = 48) needed 3 or 4 (n=18) sessions. Mean volumes during the 4 sessions were 120.0 mL, 114.9 mL, 106.5 mL, and 97.8 mL. Four patients were finally treated with a blood patch. CONCLUSIONS:The use of fine gauge pencil-point needles may reduce the incidence of PDPH. The technique of repeated caudal saline injections is easy, rapid, and effective in providing the patient with almost immediate headache relief. In cases where this treatment fails, a blood patch should be considered. Observations from this study suggest that randomized, controlled, double-blind studies may be warranted.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Abdulla S,Abdulla W,Eckhardt Rsubject
Has Abstractpub_date
2011-05-01 00:00:00pages
271-9issue
3eissn
1533-3159issn
2150-1149journal_volume
14pub_type
杂志文章相关文献
Pain Physician文献大全abstract:BACKGROUND:Prescription opioid analgesics (POA) are widely used in the pharmacotherapeutic treatment of acute and chronic pain in North America, where nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in recent years. Existing epidemiological data suggest an association between N...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2013-11-01 00:00:00
abstract:STUDY DESIGN:Electrical stimulation of the right cervical medial branches with or without the third occipital nerves was performed in nine subjects for a total of forty-eight medial branches and eight third occipital nerves. The referral patterns of each nerve or nerve branch was mapped on a human line diagram. These d...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:The growth of interventional pain medicine in recent years has resulted in more procedures being carried out under fluoroscopic guidance. The proximity of the pain physician (PP) to ionization radiation (IR) potentially increases the risk of radiation exposure to the ocular region. A European directive has r...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Therapeutic lumbar facet joint interventions are implemented to provide long-term pain relief after the facet joint has been identified as the basis for low back pain. The therapeutic lumbar facet joint interventions generally used for the treatment of low back pain of facet joint origin are intraarticular f...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Cervicogenic headache descriptors include its unilateral nature, "signs and symptoms linking it to the neck," and trauma of the neck. Since the pain often occurs over the C2 or C3 nerve root, we used a modification of the deep cervical block technique for treatment of this refractory type headache. OBJECTIV...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:While most trials of thoracic paravertebral nerve blocks (TPVB) for breast surgery show benefit, their effect on postoperative pain intensity, opioid consumption, and prevention of chronic postsurgical pain varies substantially across studies. Variability may result from use of different drugs and techniques...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Chronic neck pain is a common problem in the adult population with a typical 12-month prevalence of 30% to 50%, and 14% of the patients reporting grade II to IV neck pain with high pain intensity and disability that has a substantial impact on health care and society. Cervical epidural injections for managin...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Opioid misuse and abuse occurring in association with the treatment of chronic non-cancer pain are not new phenomena, but their increasing prevalence in recent years is unprecedented. Advancements in pharmaceutical technologies have provided opioid-related drugs, which lack the pure mu agonist activity chara...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Neuropathic pain (NP) is a major public health problem worldwide. Because of the unclear mechanism of NP, its treatment is one of the most difficult medical problems. As a targeted, noninvasive, safe therapy, pulsed radiofrequency (PRF) provides a new method for the treatment of NP; however, its effect on th...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Symptomatic lumbar spinal stenosis is a condition affecting a growing number of individuals resulting in significant disability and pain, leading to a multitude of interventions ranging from simple over the counter medication to opioids, and, finally, to complex surgical fusions. After failure of conservativ...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2019-11-01 00:00:00
abstract:AIM:To report the presentation of complex regional pain syndrome-1 (CRPS-1) as deQuervain's stenosing tenosynovitis (DQST). CASE REPORT:A 24-year-old woman presented with 3-year history of clinical diagnostic criteria (CDC) of CRPS-1. Conservative and surgical treatment for this as DQST had failed to relieve her. We d...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Among the multiple modalities of treatments available in managing chronic spinal pain, including surgery and multiple interventional techniques, epidural injections by various routes, such as interlaminar epidural injections, caudal epidural injections, transforaminal epidural injections, and percutaneous ad...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that ca...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Diversity of treatments used for headache, and varied quality of research conduct and reporting make it difficult to accurately assess the literature and to determine the best treatment(s) for patients. OBJECTIVES:To compare the quality of available research evidence describing the effects and outcomes of c...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Pain arising from the lumbar facet joints is a common cause of axial back pain in adults. Radiofrequency neurotomy (RFN) of the medial branches of the spinal dorsal rami has been used as a treatment option. The most common side effect is transient, localized, burning, neuritic-type pain, termed post-neurotom...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Corticosteroids have been used for the past 70 years in the treatment of various musculoskeletal conditions. This includes its use for joint pain such as rheumatoid arthritis and osteoarthritis. OBJECTIVES:A narrative review of the literature from its initial discovery to the present day to summarize the re...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Ther...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2017-03-01 00:00:00
abstract::Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of a vertebral body with bone cement, generally polymethylmethacrylate (PMMA). Kyphoplasty is the placement of balloons (called "tamps") into the vertebral body wit...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Opioid abuse has continued to increase at an alarming rate since our last opioid guidelines were published in 2005. Available evidence suggests a continued wide variance in the use of opioids, as documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement Administra...
journal_title:Pain physician
pub_type: 杂志文章,实务指引,评审
doi:
更新日期:2008-03-01 00:00:00
abstract:UNLABELLED:The stellate ganglion block has been utilized in a variety of painful conditions ranging from sympathetically mediated pain in the upper extremity to the pain associated with intractable angina. A number of techniques are used to block the stellate ganglion. OBJECTIVE:To describe a new and easy approach to ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:One of the most important issues that interventional physicians address during treatment is informing patients of their treatment options. Prior to beginning treatment, patients are given this information and allowed the opportunity to ask questions. Minimal qualitative information exists as to how much of t...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Accumulating experimental and clinical evidence supports the hypothesis that complex regional pain syndrome type I (CRPS-I) may be a small fiber neuropathy. OBJECTIVES:To evaluate the use of commercially available standard biopsy methods to detect intradermal axon pathology in CRPS-I, and to ascertain if th...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Pulsed radiofrequency (PRF) therapy is a clinical treatment utilizing electromagnetic energy aimed to relieve neuropathic pain. This is the first study examining the modulated expression of pain regulatory genes following the induction of the spared nerve injury (SNI) pain model and subsequently treated with...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Hemiplegic shoulder pain is one of the most common complications after stroke. Although there are many treatment strategies for this complication, sometimes very resistant cases are also seen. OBJECTIVES:To evaluate the effect of suprascapular nerve pulsed radiofrequency (PRF) treatment for hemiplegic shoul...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. OBJECTIVES:To establish an effective and novel nomogram for ICL following PVP...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Several meta-analyses have been performed to compare unilateral percutaneous kyphoplasty (PKP) and bilateral PKP in the treatment of osteoporotic vertebral compression fractures (OVCFs), but inconsistencies in the results have led to questions as to which technique is preferable. OBJECTIVE:This study was de...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Pain clinicians have always been challenged by the variability of response to pain treatment. Differences in the degree of pain stimulation and pain sensitivity, weight and age differences, prior opioid use and tolerance, as well as the differences in bioavailability of various opioid formulations have been ...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or all...
journal_title:Pain physician
pub_type: 杂志文章,实务指引
doi:
更新日期:2019-01-01 00:00:00