1
|
Reis AE, Spano M, Davis-Hayes C, Salama GR. Lumbar Puncture Complications: A Review of Current Literature. Curr Pain Headache Rep 2024; 28:803-813. [PMID: 38776003 DOI: 10.1007/s11916-024-01262-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 07/26/2024]
Abstract
PURPOSE OF REVIEW This paper reviews the complications of lumbar puncture with a focus on post-dural puncture headache including pathophysiology, risk factors, prevention, and treatment. RECENT FINDINGS Recent research has focused on understanding the multifactorial mechanisms of post-dural puncture headache and improving prevention and treatment strategies. Small caliber, pencil-point type needles are encouraged to minimize the risk of post-dural puncture headaches, especially in populations that are at higher risk for complication. While new medications and procedures show promise in small cohorts, conservative medical management and epidural blood patch are still the first and second-line treatments for PDPH. Post-dural puncture headache is the most frequent complication of lumbar puncture. There are both modifiable and nonmodifiable risk factors to consider when performing this procedure. Conservative medical management and procedure-based therapies exist for when complications of lumbar puncture arise.
Collapse
Affiliation(s)
- Alexandra E Reis
- Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA
| | - Matthew Spano
- Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA
| | - Cecilia Davis-Hayes
- Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA
| | - Gayle R Salama
- Division of Neuroradiology, Department of Radiology, Weill Cornell Medicine - New York Presbyterian Hospital, 525 East 68th Street Box 141, New York, NY, 10065, USA.
| |
Collapse
|
2
|
Lilamand M, Vrillon A, Gonzales-Marabal L, Sindzingre L, Götze K, Boddaert J, Pautas E, François-Fasille V, Dumurgier J, Paquet C. Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics. Eur Geriatr Med 2023:10.1007/s41999-023-00769-y. [PMID: 36976436 DOI: 10.1007/s41999-023-00769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To assess the skill level and self-confidence of medical residents in geriatrics with regard to conducting the lumbar puncture (LP) procedure and to study the potential benefits of training with simulation and virtual reality. METHODS First, a questionnaire survey was conducted among all French residents in geriatrics in the Paris area to assess their knowledge and self-confidence regarding the practice of LP in older adults. Second, we set up a simulation LP training session combined with virtual reality (3D video) training for selected respondents of the first survey. Third, we performed post-simulation survey for the attendees of the simulation training. Finally, a follow-up survey was conducted to examine the change in self-confidence and the success rate in clinical practice. RESULTS Fifty-five residents responded to the survey (response rate = 36.4%). The importance of mastering LP was fully recognized by the residents in geriatrics (95.3%), so most of them (94.5%) advocated for the need for additional practical training. Fourteen residents took part in the training (average rating = 4.7 on a 5-point scale). Simulation was regarded by 83% of the respondents as the most useful tool for their practice. We observed a significant pre/post-training mean improvement in self-estimated success of 20.6% (Wilcoxon matched-pairs signed-rank W = - 36, p = 0.008). The post-training success rate of the residents in real-life clinical practice was good (85.8%). CONCLUSION Residents were aware of the importance of mastering LP and requested additional training. Simulation may represent a major driver to improve their self-confidence and practical skills.
Collapse
Affiliation(s)
- Matthieu Lilamand
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France.
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France.
- Université Paris Cité, INSERM, UMRS 1144, Paris, France.
| | - Agathe Vrillon
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
| | | | - Louise Sindzingre
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Karl Götze
- Department of Geriatrics Hôpital Bretonneau, AP-HP.Nord Université Paris Cité, Paris, France
| | - Jacques Boddaert
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
| | - Eric Pautas
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
- Department of Geriatrics Hôpital Charles Foix, AP-HP, Sorbonne Université, Ivry-sur-Seine, France
| | - Véronique François-Fasille
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France
| | - Julien Dumurgier
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Claire Paquet
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
| |
Collapse
|
3
|
An J, Lee SE, Ko Y, Yang H. An unexpected effect of traumatic and bloody lumbar puncture among patients with primary headaches in emergency department. Am J Emerg Med 2023; 68:175-178. [PMID: 37030085 DOI: 10.1016/j.ajem.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association between traumatic tap and the incidence of post-dural puncture headache (PDPH) following lumbar puncture (LP) among patients who underwent LP with a primary discharge diagnosis of primary headache in the emergency department (ED). METHODS We retrospectively reviewed the medical records of patients who visited a single tertiary ED with the symptom of a headache and underwent LP for cerebrospinal fluid (CSF) analysis between January 2012 and January 2022. Patients who met the definition of PDPH and revisited the ED or outpatient clinic within 2 weeks of discharge were included. For comparative analysis, we divided the groups according to CSF RBC counts (group 1, CSF RBC <10 cells/μL; group 2, 10-100 cells/μL; group 3, ≥100 cells/μL). The primary outcome was the difference in CSF RBC counts between the ED or outpatient clinic revisiting patients who underwent LP within 2 weeks after discharge from the ED. The secondary outcomes were the admission rate and risk factors for PDPH; sex, age, needle size, and CSF pressure. RESULTS Data from 112 patients were collected; PDPH was reported in 39 patients (34.8%), and 40 (35.7%) patients were admitted. The median (interquartile range) CSF RBC count was 10 [2-100.8] cells/μL. One-way analysis of variance test of the mean differences among the three groups showed no differences in age, the duration of headache before LP, PLT counts, PT, or aPTT among the groups. There were differences in the number of admitted patients (30 vs. 7 vs. 3, P < 0.001) and the incidence of PDPH (29 vs. 6 vs. 4, P < 0.003). In the comparison of the PDPH and non-PDPH groups, there were differences in age (28.7 ± 8.4 years vs. 36.9 ± 18.4 years, P = 0.01) and the admission rate (85% vs. 9%, P < 0.001). CONCLUSIONS Notably, our results suggest that traumatic LP may be an unexpected factor in reducing the occurrence rate of PDPH. Consequently, the admission rate for PDPH was significantly reduced among patients with traumatic LP and those with primary headaches. In this study, we collected and analyzed the data from a relatively small sample size of 112 patients. Further studies are needed to evaluate the relationship between traumatic LP and PDPH.
Collapse
|
4
|
Sievänen H, Kari J, Eskola V, Huurre A, Soukka H, Palmu S. Incidence of traumatic lumbar punctures in adults: the impact of a patient's first procedure. Clin Med (Lond) 2023; 23:31-37. [PMID: 36650062 PMCID: PMC11046507 DOI: 10.7861/clinmed.2022-0169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Lumbar puncture (LP) is a widely used diagnostic method in patients of all ages. Blood-contaminated cerebrospinal fluid samples are frequent and may compromise diagnostic accuracy. OBJECTIVES We determined age-specific incidences of traumatic LPs (TLPs) in adults and examined factors that accounted for the incidence of TLPs. METHODS Erythrocyte count data from 15,812 LP procedures (2,404 were performed twice) were collected from hospital records of patients aged from 18 to 104 years. The incidence of TLPs in a patient's second LP procedure was evaluated with logistic regression analysis using the first LP, the time between the procedures and age as predictors. RESULTS The incidence of TLP in the second procedure was at least double that in the first procedure. If the first procedure was traumatic, the odds ratio of a TLP in the second procedure was 7-40-fold. One day between the successive procedures was associated with an over 10-fold odds ratio increase of TLP, and a week was still 4-8-fold odds ratio increase. Age was also associated with the incidence of TLP. CONCLUSIONS Two factors (a week or less between a patient's two LP procedures or a traumatic first LP) multiply the odds of the second procedure being traumatic and contribute to whether a patient's following LP procedure is successful.
Collapse
Affiliation(s)
| | | | - Vesa Eskola
- Tampere University Hospital, Tampere, Finland and Tampere University, Tampere, Finland
| | - Anu Huurre
- Turku University Hospital, Turku, Finland and University of Turku, Turku, Finland
| | - Hanna Soukka
- Turku University Hospital, Turku, Finland and University of Turku, Turku, Finland
| | - Sauli Palmu
- Tampere University Hospital, Tampere, Finland and Tampere University, Tampere, Finland
| |
Collapse
|
5
|
Voelker A, Pirlich M, Heyde CE. Complications of injections in conservative treatment of degenerative spine disease: a prospective unicentric study. BMC Musculoskelet Disord 2022; 23:1002. [PMID: 36419001 PMCID: PMC9682701 DOI: 10.1186/s12891-022-05970-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Spinal injection has been an accepted part of conservative therapy for degenerative diseases. The drugs used can cause side effects and severe complications. The aim of this study was to determine the occurrence of general side effects (GSE) and complications when performing consecutive different types of spinal injections and to evaluate pain reduction. METHODS Prospective data evaluation of patients with degenerative spine disease at hospital admission, discharge, and six and 12 weeks after discharge. All patients received a specific injection protocol depending on their symptoms and radiological findings. The injections performed were dorsal sacroiliac joint injections, perineural injections, epidural interlaminar and epidural periradicular injections, and facet joint injections. Potential complications were categorized and recorded as GSE and complications. In addition, the Numerical Analog Scale (NAS) for pain, the Oswestry Disability Index (ODI) were evaluated. RESULTS Forty-eight patients were enrolled. There were 282 spinal injections performed. A total of 131 common treatment-related events were recorded. Depending on the type of injection, transient pain at the injection site (32.4-73.5%), radiating pain (9.4-34.7%), and nerve root irritation (2-18.4%) were the most common. One complication with postpuncture syndrome occurred with epidural-interlaminar injection. No persistent neurologic deficits occurred. The highest rate of GSE was observed with periradicular injections (relative frequency (RF) = 0.8), followed by epidural-interlaminar injections (RF = 0.65), least frequently with FJ injections (RF = 0.32). From the time of admission to discharge, NAS scores were significantly decreased and ODI score significantly improved at discharge (p < 0.001), but relapse occurred at the 12-week follow-up. CONCLUSIONS Various consecutive spinal injections for conservative treatment of degenerative spine diseases are safe and lead to a decrease in pain and improvement in quality of life. GSE are common, but not persistent. Although complications are rare, they can have serious consequences for the patient.
Collapse
Affiliation(s)
- Anna Voelker
- grid.411339.d0000 0000 8517 9062Department for Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Markus Pirlich
- grid.411339.d0000 0000 8517 9062Clinic of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Christoph-Eckhard Heyde
- grid.411339.d0000 0000 8517 9062Department for Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| |
Collapse
|
6
|
Giagkou N, Spanou I, Mitsikostas DD. Current perspectives on the recognition and diagnosis of low CSF pressure headache syndromes. Expert Rev Neurother 2022; 22:815-827. [PMID: 36453212 DOI: 10.1080/14737175.2022.2152674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Headaches occur when cerebrospinal fluid (CSF) pressure drops following dural puncture or trauma or spontaneously. As the features of these headaches and their accompanying symptoms might not be typical, low CSF pressure headache syndromes, and spontaneous intracranial hypotension in particular, are often misdiagnosed and underdiagnosed. AREAS COVERED The aim of this narrative review is to summarize the most recent evidence regarding the clinical presentation and the diagnosis of low CSF pressure headache syndromes. EXPERT OPINION The clinical spectrum low CSF pressure headache syndromes varies significantly and key signs might be missing. Low CSF pressure headache syndromes should be included in the differential diagnosis of any case of refractory headache, even when the headache is not orthostatic, or there are normal neuroimaging findings, and/or lumbar puncture opening pressure is within normal limits. Future research should focus on controlled interventional studies on the treatment of low CSF pressure headache syndromes, which are currently lacking.
Collapse
Affiliation(s)
- Nikolaos Giagkou
- 1 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Spanou
- 1 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimos D Mitsikostas
- 1 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
7
|
Mizu D, Matsuoka Y, Huh JY, Kamitani Y, Fujiwara S, Ariyoshi K. The necessity of lumbar puncture in adult emergency patients with fever-associated seizures. Am J Emerg Med 2022; 58:120-125. [DOI: 10.1016/j.ajem.2022.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/06/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022] Open
|
8
|
Camporesi E, Nilsson J, Vrillon A, Cognat E, Hourregue C, Zetterberg H, Blennow K, Becker B, Brinkmalm A, Paquet C, Brinkmalm G. Quantification of the trans-synaptic partners neurexin-neuroligin in CSF of neurodegenerative diseases by parallel reaction monitoring mass spectrometry. EBioMedicine 2022; 75:103793. [PMID: 34990894 PMCID: PMC8743209 DOI: 10.1016/j.ebiom.2021.103793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Synaptic proteins are increasingly studied as biomarkers for synaptic dysfunction and loss, which are early and central events in Alzheimer's disease (AD) and strongly correlate with the degree of cognitive decline. In this study, we specifically investigated the synaptic binding partners neurexin (NRXN) and neuroligin (Nlgn) proteins, to assess their biomarker's potential. METHODS we developed a parallel reaction monitoring mass spectrometric method for the simultaneous quantification of NRXNs and Nlgns in cerebrospinal fluid (CSF) of neurodegenerative diseases, focusing on AD. Specifically, NRXN-1α, NRXN-1β, NRXN-2α, NRXN-3α and Nlgn1, Nlgn2, Nlgn3 and Nlgn4 proteins were targeted. FINDINGS The proteins were investigated in a clinical cohort including CSF from controls (n=22), mild cognitive impairment (MCI) due to AD (n=44), MCI due to other conditions (n=46), AD (n=77) and a group of non-AD dementia (n=28). No difference in levels of NRXNs and Nlgns was found between AD (both at dementia and MCI stages) or controls or the non-AD dementia group for any of the targeted proteins. NRXN and Nlgn proteins correlated strongly with each other, but only a weak correlation with the AD core biomarkers and the synaptic biomarkers neurogranin and growth-associated protein 43, was found, possibly reflecting different pathogenic processing at the synapse. INTERPRETATION we conclude that NRXN and Nlgn proteins do not represent suitable biomarkers for synaptic pathology in AD. The panel developed here could aid in future investigations of the potential involvement of NRXNs and Nlgns in synaptic dysfunction in other disorders of the central nervous system. FUNDING a full list of funding can be found under the acknowledgments section.
Collapse
Affiliation(s)
- Elena Camporesi
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Johanna Nilsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Agathe Vrillon
- Université de Paris, Cognitive Neurology Center, GHU Nord APHP Hospital Lariboisière Fernand Widal, Paris, France; Université de Paris, Inserm UMR S11-44 Therapeutic Optimization in Neuropsychopharmacology, Paris, France
| | - Emmanuel Cognat
- Université de Paris, Cognitive Neurology Center, GHU Nord APHP Hospital Lariboisière Fernand Widal, Paris, France; Université de Paris, Inserm UMR S11-44 Therapeutic Optimization in Neuropsychopharmacology, Paris, France
| | - Claire Hourregue
- Université de Paris, Cognitive Neurology Center, GHU Nord APHP Hospital Lariboisière Fernand Widal, Paris, France
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Bruno Becker
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ann Brinkmalm
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Claire Paquet
- Université de Paris, Cognitive Neurology Center, GHU Nord APHP Hospital Lariboisière Fernand Widal, Paris, France; Université de Paris, Inserm UMR S11-44 Therapeutic Optimization in Neuropsychopharmacology, Paris, France
| | - Gunnar Brinkmalm
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| |
Collapse
|
9
|
Bouwman FH, Frisoni GB, Johnson SC, Chen X, Engelborghs S, Ikeuchi T, Paquet C, Ritchie C, Bozeat S, Quevenco F, Teunissen C. Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12314. [PMID: 35496374 PMCID: PMC9044123 DOI: 10.1002/dad2.12314] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/01/2022] [Accepted: 03/28/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Femke H. Bouwman
- Alzheimer Center Amsterdam Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | | | - Sterling C. Johnson
- University of Wisconsin‐Madison, and Geriatric Research Education and Clinical Center of the William S. Middleton Memorial Veterans Hospital Madison Wisconsin USA
| | | | - Sebastiaan Engelborghs
- Center for Neurosciences (C4N) Vrije Universiteit Brussel, and Department of Neurology/Brussels Integrated Center for Brain and Memory (Bru‐BRAIN) Universitair Ziekenhuis Brussel, Brussels, and Department of Biomedical Sciences University of Antwerp Antwerp Belgium
| | | | - Claire Paquet
- Université de Paris Cognitive Neurology Center Lariboisière Hospital GHU APHP Nord INSERMU1144 Paris France
| | - Craig Ritchie
- University of Edinburgh, and Brain Health Scotland Edinburgh UK
| | | | | | - Charlotte Teunissen
- Department of Clinical Chemistry Neurochemistry Laboratory Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the Netherlands
| |
Collapse
|
10
|
Safarpour AR, Mehrabi M, Tarkesh F, Ashrafizadeh H, Keshtkar A, Askari H, Abazari D, Amini A, Barati-Boldaji R. Aminophylline for Prevention and/or Treatment of Post-Dural Puncture Headache: A Systematic Review and Meta-Analysis Study Protocol. Anesth Pain Med 2021; 11:e119674. [PMID: 35075418 PMCID: PMC8782189 DOI: 10.5812/aapm.119674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 12/18/2022] Open
Abstract
Objectives Post-dural Puncture Headache (PDPH) is prevalent among individuals undergoing lumbar punctures. The non-invasive effect of some drugs, such as aminophylline on PDPH has been investigated in several clinical studies. As there is no comprehensive systematic review and meta-analysis about the preventive and therapeutic effects of aminophylline on PDPH in the literature, the clinical effectiveness of this drug on the prevention and/or treatment of PDPH will be assessed in this study. Methods PubMed/MEDLINE, Embase, WoS (Clarivate Analytics), the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL Complete, Scopus, and Google Scholar as electronic databases will be precisely searched for clinical studies that assessed the effect of aminophylline on PDPH. Studies between 01-01-1980 and 30-06-2020 will be evaluated in this study, and there will not be any language restrictions. Contradictions between the reviewers within any phase of the study (screening, selecting, quality assessment, and data extraction) will be resolved by consensus; in case of unsolved disagreements, a third reviewer will eventually decide. The combination method will be applied according to the methodological resemblance in the selected articles using the Random Effect Model or the Fixed Effect Model. Also, for the included articles, forest plots will be drawn. For assessing statistical heterogeneity, the I2 statistic and the Q-statistic test will be applied. In addition, funnel plots will be used for assessing non-significant study effects and potential reporting bias. Furthermore, Egger’s and Begg’s tests will be done, and publication bias will be indicated by significant findings (P < 0.05). Conclusions It is expected that the results of this study will be of benefit to researchers and clinicians for managing PDPH, and will be reported in conferences and publications.
Collapse
Affiliation(s)
- Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Manoosh Mehrabi
- Department of E-Learning, Virtual School, Shiraz University of Medical Sciences, Shiraz, Iran
- Corresponding Author: Department of E-Learning, Virtual School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Firoozeh Tarkesh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadis Ashrafizadeh
- Department of Nursing, School of Nursing and Midwifery, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Askari
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Danya Abazari
- Department of Cellular & Physiological Sciences & the Brain Research Center, University of British Columbia, Vancouver, Canada
| | - Afshin Amini
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Barati-Boldaji
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
11
|
Beyaz SG, Ergönenç T, Saritaş A, Şahin F, Ülgen AM, Eman A, Doğan B. The interrelation between body mass index and post-dural puncture headache in parturient women. J Anaesthesiol Clin Pharmacol 2021; 37:425-429. [PMID: 34759556 PMCID: PMC8562432 DOI: 10.4103/joacp.joacp_249_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 01/20/2020] [Accepted: 02/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background and Aims Post-dural puncture headache is seen more frequently in pregnant women due to stress, dehydration, intra-abdominal pressure, and insufficient fluid replacement after delivery. Obesity protects against post-dural puncture headache in pregnant women; increased intra-abdominal fat tissue reduced cerebrospinal fluid leakage by increasing the pressure in the epidural space. Therefore, this study investigated the influence of body mass index on post-dural puncture headache in elective cesarean section patients in whom 27G spinal needles were used. Material and Methods The study included 464 women who underwent elective cesarean section under spinal anesthesia. Dural puncture performed with a 27G Quincke spinal needle at the L3-4 or L4-5 intervertebral space and given 12.5 mg hyperbaric bupivacaine intrathecally. The patients were questioned regarding headache and low back pain 6, 12, 24, and 48 h after the procedure, and by phone calls on days 3 and 7. Results Post-dural puncture headache developed in 38 (8.2%) patients. Of the patients who developed post-dural puncture headache, 23 (60.5%) had a body mass index <30 and 15 (39.5%) had a body mass index ≥30. Of the patients who did not develop post-dural puncture headache, 258 (60, 6%) had a body mass index <30 and 168 (39, 4%) had a body mass index ≥30. Conclusion This prospective study found the body mass index values did not affect post-dural puncture headache in the elective cesarean section performed under spinal anesthesia.
Collapse
Affiliation(s)
- Serbülent Gökhan Beyaz
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Istinye University, Istanbul, Republic of Turkey
| | - Tolga Ergönenç
- Department of Anesthesiology, Akyazı State Hospital, Sakarya, Republic of Turkey
| | - Aykut Saritaş
- Department of Anesthesiology and Reanimation, Tepecik Training and Research Hospital, İzmir, Republic of Turkey
| | - Fatih Şahin
- Department of Anesthesiology, Yenikent State Hospital, Sakarya, Republic of Turkey
| | - Ali Metin Ülgen
- Department of Anesthesiology, Sakarya University Training and Research Hospital, Sakarya, Republic of Turkey
| | - Ali Eman
- Department of Anesthesiology, Sakarya University Training and Research Hospital, Sakarya, Republic of Turkey
| | - Burcu Doğan
- Department of Family Medicine, Sakarya University Training and Research Hospital, Sakarya, Republic of Turkey
| |
Collapse
|
12
|
Affiliation(s)
- Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC
| | - Wen-Hsun Chang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
- Female Cancer Foundation, Taipei, Taiwan, ROC
| |
Collapse
|