Abstract:
OBJECTIVE:Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. CASE REPORT:An unusual case is described of an 11-year-old boy with PDPH, which was successfully managed with a ventral (anterior) epidural blood patch and epidural saline infusion after headache and other symptoms failed to resolve after conservative treatment and conventionally performed blood patches. CONCLUSIONS:Ineffectiveness of conservative measures and epidural blood patches performed posteriorly to resolve PDPH should lead the physician both to question the diagnosis of PDPH by pursuing radiographic confirmation of a cerebral spinal fluid leak and, furthermore, identification of its location to best direct further therapy.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Dʼsouza G,Seidel FG,Krane EJdoi
10.1097/AAP.0000000000000562subject
Has Abstractpub_date
2017-03-01 00:00:00pages
263-266issue
2eissn
1098-7339issn
1532-8651journal_volume
42pub_type
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2002.30708
更新日期:2002-03-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-07-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000033
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journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2000.8933
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Because of the uncertainty and limitations in available randomized controlled trials, we performed an analysis of the Medicare claims database to determine whether an association exists between postoperative epidural analgesia and mortality. METHODS:A 5% nationally random sample of Medicare beneficiaries fr...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2004.07.002
更新日期:2004-11-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000687
更新日期:2018-01-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2011-11-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000342
更新日期:2016-01-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e31820d4334
更新日期:2011-05-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2003.50129
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Recent clinical trials suggest that subfascial (sometimes termed subepineural) injections result in faster block onset and success compared with conventional techniques. This prospective, randomized, observer-blinded study measured and compared the 3-dimensional spread pattern and volume of pe...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31826af511
更新日期:2012-11-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000588
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更新日期:2019-08-09 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(99)90047-0
更新日期:1999-11-01 00:00:00
abstract::High-dose opioid administration is associated with significant adverse events. Evidence suggests that low-dose ketamine infusions improve perioperative analgesia over conventional opioid management, but usage is highly variable. Ketamine's adverse drug effects (ADEs) are well known, but their prevalence during low-dos...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000416
更新日期:2016-07-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3182424566
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.05.011
更新日期:2008-07-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.28275
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:This prospective, randomized, observer-blinded study compared ultrasound guidance and the conventional landmark-based technique for superficial cervical plexus blockade. METHODS:Forty patients were randomly allocated to receive a block of the superficial cervical plexus using ultrasound guidance (n = 20) or...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3181faa11c
更新日期:2010-11-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100531
更新日期:2019-05-21 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000578
更新日期:2017-05-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.11.006
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The ideal spread of local anesthetic for effective, rapid, and safe sciatic nerve block is debated. We hypothesized that subparaneural ultrasound-guided injection results in faster onset and has a better success rate than extraneural circumferential spread. METHODS:Patients undergoing elective tibial, foot,...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000095
更新日期:2014-07-01 00:00:00
abstract::The COVID-19 outbreak is on the world. While many countries have imposed general lockdown, emergency services are continuing. Healthcare professionals have been infected with the virulent severe acute respiratory syndrome coronavirus-2 (SARS), which spreads by close contact and aerosols. The anesthesiologist is partic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1136/rapm-2020-101541
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve blocks reduce postoperative pain and enhance recovery after total knee arthroplasty (TKA). This study aims to assess the benefits of addition of intravenous dexmedetomidine (DexM) to intravenous dexamethasone on the analgesic duration of quadruple nerve blocks. METHODS:This d...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101749
更新日期:2021-02-01 00:00:00