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Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial
INTRODUCTION: Post-dural puncture headache (PDPH) is a common complication following neuraxial anaesthesia that increases the duration of hospital stay. AIM: This study aims to evaluate the effectiveness of injection of the dexamethasone-lidocaine mixture in suboccipital muscles treatment of PDPH af...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Republic of Macedonia
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420929/ https://www.ncbi.nlm.nih.gov/pubmed/30894910 http://dx.doi.org/10.3889/oamjms.2019.105 |
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author | Abdelraouf, Mhamed Salah, Maged Waheb, Mohsen Elshall, Ahmed |
author_facet | Abdelraouf, Mhamed Salah, Maged Waheb, Mohsen Elshall, Ahmed |
author_sort | Abdelraouf, Mhamed |
collection | PubMed |
description | INTRODUCTION: Post-dural puncture headache (PDPH) is a common complication following neuraxial anaesthesia that increases the duration of hospital stay. AIM: This study aims to evaluate the effectiveness of injection of the dexamethasone-lidocaine mixture in suboccipital muscles treatment of PDPH after cesarean section. PATIENT AND METHODS: A group of 90 females with PDPH following cesarean section under spinal anaesthesia were randomly allocated into two equal groups: study group (Group S) and control group (group C). All patients received bilateral intramuscular (in the suboccipital muscle) (Group S) (n = 45) patients received lidocaine 40 mg (2 mL of 2% solution) and dexamethasone 8mg in a total volume of 4 mL; whilst, patients in the control group (group C) (n = 45) received 4 mL normal saline. The primary outcome is the Visual Analogue Score for a headache at 24 hours after injection. RESULTS: Demographic data and the baseline, headache score, neck muscle spasm, and nausea were comparable in both groups. Group S showed lower headache score compared to group C at all the post-injection time points. All patients in group S showed resolution of nausea after the intervention; while none of the control group showed any improvement. All patients of group C needed rescue analgesia; while only 6 (13.3%) patients in group S asked for an analgesic. Time to the first analgesic request was longer in group S compared to group C (10.17 ± 7.96 hours versus 1.00 ± 0.00 hours, P < 0.001). CONCLUSION: Ultrasound-guided injection of the dexamethasone-lidocaine mixture in suboccipital muscles is effective management of PDPH after CS. |
format | Online Article Text |
id | pubmed-6420929 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Republic of Macedonia |
record_format | MEDLINE/PubMed |
spelling | pubmed-64209292019-03-20 Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial Abdelraouf, Mhamed Salah, Maged Waheb, Mohsen Elshall, Ahmed Open Access Maced J Med Sci Clinical Science INTRODUCTION: Post-dural puncture headache (PDPH) is a common complication following neuraxial anaesthesia that increases the duration of hospital stay. AIM: This study aims to evaluate the effectiveness of injection of the dexamethasone-lidocaine mixture in suboccipital muscles treatment of PDPH after cesarean section. PATIENT AND METHODS: A group of 90 females with PDPH following cesarean section under spinal anaesthesia were randomly allocated into two equal groups: study group (Group S) and control group (group C). All patients received bilateral intramuscular (in the suboccipital muscle) (Group S) (n = 45) patients received lidocaine 40 mg (2 mL of 2% solution) and dexamethasone 8mg in a total volume of 4 mL; whilst, patients in the control group (group C) (n = 45) received 4 mL normal saline. The primary outcome is the Visual Analogue Score for a headache at 24 hours after injection. RESULTS: Demographic data and the baseline, headache score, neck muscle spasm, and nausea were comparable in both groups. Group S showed lower headache score compared to group C at all the post-injection time points. All patients in group S showed resolution of nausea after the intervention; while none of the control group showed any improvement. All patients of group C needed rescue analgesia; while only 6 (13.3%) patients in group S asked for an analgesic. Time to the first analgesic request was longer in group S compared to group C (10.17 ± 7.96 hours versus 1.00 ± 0.00 hours, P < 0.001). CONCLUSION: Ultrasound-guided injection of the dexamethasone-lidocaine mixture in suboccipital muscles is effective management of PDPH after CS. Republic of Macedonia 2019-02-19 /pmc/articles/PMC6420929/ /pubmed/30894910 http://dx.doi.org/10.3889/oamjms.2019.105 Text en Copyright: © 2019 Mhamed Abdelraouf, Maged Salah, Mohsen Waheb, Ahmed Elshall. http://creativecommons.org/licenses/CC BY-NC/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). |
spellingShingle | Clinical Science Abdelraouf, Mhamed Salah, Maged Waheb, Mohsen Elshall, Ahmed Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title | Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title_full | Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title_fullStr | Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title_full_unstemmed | Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title_short | Suboccipital Muscles Injection for Management of Post-Dural Puncture Headache After Cesarean Delivery: A Randomized-Controlled Trial |
title_sort | suboccipital muscles injection for management of post-dural puncture headache after cesarean delivery: a randomized-controlled trial |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420929/ https://www.ncbi.nlm.nih.gov/pubmed/30894910 http://dx.doi.org/10.3889/oamjms.2019.105 |
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