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Toma O, Persoons B, Pogatzki-Zahn E, Van de Velde M, Joshi GP. PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 2019; 74:1320-1331. [PMID: 31392721 PMCID: PMC6771830 DOI: 10.1111/anae.14796] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2019] [Indexed: 12/28/2022]
Abstract
Rotator cuff repair can be associated with significant and difficult to treat postoperative pain. We aimed to evaluate the available literature and develop recommendations for optimal pain management after rotator cuff repair. A systematic review using procedure‐specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in English from 1 January 2006 to 15 April 2019 assessing postoperative pain after rotator cuff repair using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. Out of 322 eligible studies identified, 59 randomised controlled trials and one systematic review met the inclusion criteria. Pre‐operative and intra‐operative interventions that improved postoperative pain were paracetamol, cyclo‐oxygenase‐2 inhibitors, intravenous dexamethasone, regional analgesia techniques including interscalene block or suprascapular nerve block (with or without axillary nerve block) and arthroscopic surgical technique. Limited evidence was found for pre‐operative gabapentin, perineural adjuncts (opioids, glucocorticoids, or α‐2‐adrenoceptor agonists added to the local anaesthetic solution) or postoperative transcutaneous electrical nerve stimulation. Inconsistent evidence was found for subacromial/intra‐articular injection, and for surgical technique‐linked interventions, such as platelet‐rich plasma. No evidence was found for stellate ganglion block, cervical epidural block, specific postoperative rehabilitation protocols or postoperative compressive cryotherapy. The analgesic regimen for rotator cuff repair should include an arthroscopic approach, paracetamol, non‐steroidal anti‐inflammatory drugs, dexamethasone and a regional analgesic technique (either interscalene block or suprascapular nerve block with or without axillary nerve block), with opioids as rescue analgesics. Further randomised controlled trials are required to confirm the influence of the recommended analgesic regimen on postoperative pain relief.
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Devroe S, Bleeser T, Van de Velde M, Verbrugge L, De Buck F, Deprest J, Devlieger R, Rex S. Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study. Int J Obstet Anesth 2019; 39:74-81. [DOI: 10.1016/j.ijoa.2019.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 12/22/2018] [Accepted: 01/07/2019] [Indexed: 11/28/2022]
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Joshi GP, Van de Velde M, Kehlet H. Development of evidence-based recommendations for procedure-specific pain management: PROSPECT methodology. Anaesthesia 2019; 74:1298-1304. [PMID: 31292953 PMCID: PMC6916581 DOI: 10.1111/anae.14776] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 01/21/2023]
Abstract
Effective peri‐operative pain management is a prerequisite for optimal recovery after surgery. Despite published evidence‐based guidelines from several professional groups, postoperative pain management remains inadequate. The procedure‐specific pain management (PROSPECT) collaboration consists of anaesthetists and surgeons with broad international representation that provide healthcare professionals with practical and evidence‐based recommendations formulated in a way that facilitates clinical decision‐making across all stages of the peri‐operative period on a procedure‐specific basis. The aim of this manuscript is to provide a detailed description of the current PROSPECT methodology with the intention of providing the rigour and transparency in which procedure‐specific pain management recommendations are developed. The high methodological standards of the recommendations should improve the quality of clinical practice.
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Missant C, Teunkenst A, Vandermeersch E, Van de Velde M. Patient-controlled Epidural Analgesia following Combined Spinal-epidural Analgesia in Labour: The Effects of Adding a Continuous Epidural Infusion. Anaesth Intensive Care 2019; 33:452-6. [PMID: 16119485 DOI: 10.1177/0310057x0503300405] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient-controlled epidural analgesia (PCEA) is used to maintain epidural analgesia following initial intrathecal analgesia. This trial investigated whether a continuous background infusion with PCEA provides superior analgesia to PCEA alone among patients who received combined spinal-epidural (CSE) analgesia during labour. Eighty parturients were randomized to either PCEA alone (PCEA) or PCEA with a background infusion of ropivacaine 0.15% with sufentanil 0.75 μg/ml at 2 ml/h (PCEA+CEI). PCEA settings were a bolus of 4 ml of the same analgesic solution with a lockout interval of 15 minutes. Significantly more patients in the PCEA group required at least one anaesthetist intervention for breakthrough pain (27 [71%] vs 10 [25%] in the PCEA+CEI group, P<0.05). Consumption of local anaesthetic (excluding manually administered boluses) was similar between the groups. If anaesthetist-administered boluses were included, more local anaesthetic was consumed by the PCEA group (47.1±19.4 mg vs 35.6±12.0 mg in the PCEA+CEI group, P<0.05). We conclude that PCEA with a background infusion provides effective analgesia with less anaesthetist workload and reduced local anaesthetic consumption as compared with PCEA without a background infusion.
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MESH Headings
- Adult
- Amides/administration & dosage
- Analgesia, Epidural/adverse effects
- Analgesia, Epidural/methods
- Analgesia, Obstetrical/adverse effects
- Analgesia, Obstetrical/methods
- Analgesia, Patient-Controlled/adverse effects
- Analgesia, Patient-Controlled/methods
- Analgesics, Opioid/administration & dosage
- Anesthetics, Combined/administration & dosage
- Anesthetics, Combined/therapeutic use
- Anesthetics, Local/administration & dosage
- Double-Blind Method
- Female
- Humans
- Infusions, Intravenous/methods
- Injections, Spinal/methods
- Pain/prevention & control
- Pain Measurement/statistics & numerical data
- Ropivacaine
- Sufentanil/administration & dosage
- Sufentanil/adverse effects
- Time Factors
- Treatment Outcome
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Barazanchi A, MacFater W, Rahiri JL, Tutone S, Hill A, Joshi G, Kehlet H, Schug S, Van de Velde M, Vercauteren M, Lirk P, Rawal N, Bonnet F, Lavand'homme P, Beloeil H, Raeder J, Pogatzki-Zahn E. Evidence-based management of pain after laparoscopic cholecystectomy: a PROSPECT review update. Br J Anaesth 2018; 121:787-803. [DOI: 10.1016/j.bja.2018.06.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/19/2018] [Accepted: 07/09/2018] [Indexed: 02/07/2023] Open
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Smits K, Roels K, Ververs C, Van de Velde M, Govaere J, Van Soom A. Fluorinert as an Alternative for Mercury in Piezo Drill Assisted ICSI in the Horse. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.05.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Govaere J, Roels K, Ververs C, Van de Velde M, De Lange V, Gerits I, Hoogewijs M, Van Soom A. Ascending placentitis in the mare. VLAAMS DIERGEN TIJDS 2018. [DOI: 10.21825/vdt.v87i3.16074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ascending placentitis in the mare, which affects 3 to 7% of pregnancies, is a common cause of abortion, premature birth and delivery of compromised foals (Troedsson, 2003; LeBlanc, 2010). Since the infection ascends from the caudal genital tract, the first and most distinct lesions are seen near the caudal pole area of the allantochorion adjacent to the cervix. The symptoms are not always obvious or will be exhibited only at a later stage of the disease process, which renders timely adequate treatment difficult. Moreover, experimental models of placentitis in the mare are difficult to maintain and double-blind, controlled studies are scarce, making it hard to formulate clear science-based advice. In this paper, the diagnosis is discussed on the basis of the symptoms, the ultrasound examinations and the endocrinological parameters, and the therapeutic and prognostic considerations are evaluated.
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Nijs K, Nulens K, Dubois J, Van de Velde M, Stessel B. In reply: steroids, atosiban and pulmonary oedema; are or may be a cause? Int J Obstet Anesth 2018. [PMID: 29534949 DOI: 10.1016/j.ijoa.2018.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nijs K, Nulens K, Dubois J, Van de Velde M, Stessel B. The combination of corticosteroid and tocolytic therapy in a preeclamptic patient is a risk factor for the development of acute pulmonary oedema. Int J Obstet Anesth 2018; 34:113-114. [PMID: 29343418 DOI: 10.1016/j.ijoa.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 12/17/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022]
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Kinsella SM, Carvalho B, Dyer RA, Fernando R, McDonnell N, Mercier FJ, Palanisamy A, Sia ATH, Van de Velde M, Vercueil A. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. Anaesthesia 2017; 73:71-92. [DOI: 10.1111/anae.14080] [Citation(s) in RCA: 233] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 11/28/2022]
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Joshi G, Kehlet H, Beloeil H, Bonnet F, Fischer B, Hill A, Joshi G, Kehlet H, Lavandhomme P, Lirk P, Pogatzki-Zhan E, Raeder J, Rawal N, Schug S, Van de Velde M. Guidelines for perioperative pain management: need for re-evaluation. Br J Anaesth 2017; 119:703-706. [DOI: 10.1093/bja/aex304] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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37
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De Lange L, Roels K, Ververs C, Van de Velde M, Corty P, Govaere J. Diagnostische benadering van cryptorchidie bij de hengst. VLAAMS DIERGEN TIJDS 2017. [DOI: 10.21825/vdt.v86i3.16284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
De diagnose van cryptorchidie bij het paard is vaak een uitdaging aangezien niet altijd definitief uitsluitsel kan gegeven worden op basis van de anamnese, het klinische onderzoek en het rectaal en echografisch onderzoek. Verschillende endocrinologische diagnostische testen zoals de bepaling van het testosteron-, androstenedione-, oestrogenen-, urinaire steroïden- en het antimülleriaans hormoongehalte, die de aanwezigheid van testiculair weefsel aantonen, zijn beschreven. In dit artikel wordt getracht om de voor- en nadelen van deze testen te vergelijken, zodat practici een idee krijgen welke testen in de praktijk gebruikt kunnen worden.
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Dewinter G, Moens P, Fieuws S, Vanaudenaerde B, Van de Velde M, Rex S. Systemic lidocaine fails to improve postoperative morphine consumption, postoperative recovery and quality of life in patients undergoing posterior spinal arthrodesis. A double-blind, randomized, placebo-controlled trial. Br J Anaesth 2017; 118:576-585. [DOI: 10.1093/bja/aex038] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 02/06/2023] Open
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Van de Velde M, Carvalho B. In reply. Int J Obstet Anesth 2016; 28:96. [PMID: 27836392 DOI: 10.1016/j.ijoa.2016.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 11/19/2022]
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Van de Velde M, Carvalho B. In reply. Int J Obstet Anesth 2016; 27:92-3. [PMID: 27432691 DOI: 10.1016/j.ijoa.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/25/2016] [Indexed: 11/28/2022]
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Keller P, Dufourni A, Van de Velde M, Bauwens C, Van Loon G. Phenylephrine-induced epistaxis in a six-year-old Quarter horse with nephrosplenic entrapment. VLAAMS DIERGEN TIJDS 2016. [DOI: 10.21825/vdt.v85i3.16343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Left dorsal displacement of the large colon is a common cause of colic in horses. Treatment consists of surgery, rolling the horse under general anesthesia or intravenous administration of phenylephrine. Treatment with phenylephrine, an α1-adrenergic drug, is often associated with sweating and trembling. Especially in horses of more than 15 years old, fatal hemorrhage may occur due to hemothorax or hemoperitoneum. Therefore, phenylephrine treatment is generally not given in horses over 15 years of age. In this report, severe epistaxis in a six-year-old Quarter horse is described after intravenous administration of 22.5 μg/kg BW phenylephrine, and it is highlighted that hemorrhage may also occur in younger horses.
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Maas E, Pieters B, Van de Velde M, Rex S. General or Local Anesthesia for TAVI? A Systematic Review of the Literature and Meta-Analysis. Curr Pharm Des 2016; 22:1868-78. [DOI: 10.2174/1381612822666151208121825] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/07/2015] [Indexed: 11/22/2022]
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Van de Velde M, Carvalho B. Remifentanil for labor analgesia: an evidence-based narrative review. Int J Obstet Anesth 2016; 25:66-74. [DOI: 10.1016/j.ijoa.2015.12.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/25/2015] [Accepted: 12/12/2015] [Indexed: 11/30/2022]
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Teunkens A, Cootjans K, Vermeulen K, Peters M, Van de Velde M, Rex S. Intraoperative administered tramadol reduces the need for piritramide in the immediate postoperative period in children undergoing adenotonsillectomy: A retrospective observational study. ACTA ANAESTHESIOLOGICA BELGICA 2016; 67:175-181. [PMID: 29873987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Adenotonsillectomy is a frequently performed procedure in pediatric day-case surgery causing significant pain for which adequate analgesia is required. Our aim was to investigate if the intraoperative administration of IV tramadol decreases the need for postoperative pain medication in children. Because tramadol has well-known pro-emetic effects, we also assessed the incidence of postoperative nausea and vomiting (PONV). METHODS We performed a retrospective observational study in 314 children aged 1-13 years undergoing elective adenotonsillectomy. We identified 160 children who had received standard pain medication consisting of IV paracetamol and ketorolac and compared them with a group of 154 children who had received in addition a perioperative infusion of tramadol. RESULTS 32.5% of the patients in the tramadol group versus 83.8% of the patients in the standard group required postoperative administration of piritramide (p < 0.0001). Groups did not differ with respect to the postoperative need for anti-emetics but in the tramadol group more patients had received prophylactic therapy with odansetron or dexamethasone (P < 0.0001). CONCLUSION The results of this retrospective study indicate that intraoperative tramadol administration in combination with prophylactic antiemetic therapy decreases the need for piritramide in the immediate postoperative period without increasing the incidence of PONV after tonsillectomy in children.
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Van de Velde M, Devroe S, Roofthooft E. Remifentanil PCIA for labour analgesia: a world of caution. ACTA ANAESTHESIOLOGICA BELGICA 2016; 67:149-150. [PMID: 29873984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Al tmimi L, Van Hemelrijck J, Van de Velde M, Sergeant P, Meyns B, Missant C, Jochmans I, Poesen K, Coburn M, Rex S. Xenon anaesthesia for patients undergoing off-pump coronary artery bypass graft surgery: a prospective randomized controlled pilot trial †. Br J Anaesth 2015; 115:550-9. [DOI: 10.1093/bja/aev303] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Devroe S, Van de Velde M, Demaerel P, Van Calsteren K. Spinal subdural haematoma after an epidural blood patch. Int J Obstet Anesth 2015; 24:288-9. [DOI: 10.1016/j.ijoa.2015.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/12/2015] [Accepted: 05/26/2015] [Indexed: 11/25/2022]
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Desmet M, Vanneste B, Reynvoet M, Van Cauwelaert J, Verhelst L, Pottel H, Missant C, Van de Velde M. A randomised controlled trial of intravenous dexamethasone combined with interscalene brachial plexus blockade for shoulder surgery. Anaesthesia 2015; 70:1180-5. [PMID: 26082203 DOI: 10.1111/anae.13156] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 11/27/2022]
Abstract
We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0-14.1 [1.8-48]) h, which was extended by intravenous dexamethasone 2.5 mg and 10 mg to 17.4 (14.9-21.5 [7.2-48]) h, p < 0.0001, and 20.1 (17.2-24.3 [1.3-48]) h, p < 0.0001, respectively, but not by dexamethasone 1.25 mg, 14.0 (12.1-17.7 [2.1-48]) h, p = 0.05. Postoperative analgesia was given sooner after rotator cuff repair than subacromial decompression, hazard ratio (95% CI) 2.2 (1.6-3.0), p < 0.0001, but later in older participants, hazard ratio (95% CI) 0.98 (0.97-0.99) per year, p < 0.0001.
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Verstraete S, Walters MA, Devroe S, Roofthooft E, Van de Velde M. Lower incidence of post-dural puncture headache with spinal catheterization after accidental dural puncture in obstetric patients. Acta Anaesthesiol Scand 2014; 58:1233-9. [PMID: 25307708 DOI: 10.1111/aas.12394] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Accidental dural puncture (ADP) and post-dural puncture headache (PDPH) are important complications of obstetric regional anesthesia. Inserting the catheter intrathecally after ADP to prevent PDPH has gained popularity. Nonetheless, data on the effect of an intrathecal catheter on PDPH and epidural blood patch (EBP) rates are mixed. Our primary objective was to examine if spinal catheterization reduces the incidence of PDPH after ADP in obstetric patients. METHODS Anesthetic records of 29,749 regional blocks performed between January 1997 and July 2013 were analyzed retrospectively. In all blocks containing an epidural component, 18-gauge epidural needles were used. All patients who experienced a witnessed ADP or PDPH without ADP were identified. Data from patients with or without a prolonged spinal catheter were compared. RESULTS There were 128 events of witnessed ADP (0.43%). Following known ADP, 39 women had an epidural catheter placed at a different level and 89 had an intrathecal catheter (20-gauge) for at least 24 h. Sixty-one patients developed PDPH after observed ADP (48%). Prolonged intrathecal catheter placement significantly reduced the incidence of PDPH after ADP to 42% compared with 62% in those who have the catheter re-sited epidurally [odds ratio = 2.3 (95% confidence interval 1.04-4.86); P = 0.04]. CONCLUSIONS The incidence of ADP, PDPH and blood patching is similar with previously published studies. After witnessed ADP, inserting the epidural catheter intrathecally significantly reduced the incidence of PDPH.
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