Abstract

BAYTER, Alejandro; IBANEZ, Fabián; GARCIA, Mario  and  MELENDEZ, Héctor Julio. Cefalea post-punción en pacientes sometidas a cesárea bajo anestesia subaracnoidea . Eficacia de la posición sentada versus decúbito lateral. Ensayo clínico controlado . Rev. colomb. anestesiol. [online]. 2007, vol.35, n.2, pp.121-127. ISSN 0120-3347.

Objectives: To determine the incidence of postdural puncture headache in connection with the position in which is carried out the punction : sitting vs. left lateral decubitus (DLI). Methods: In a prospective randomized double -blind controlled trial we investigated the effect of position in which is carried out the punction : sitting vs. left lateral decubitus (DLI). Using two groups and 202 patients. The CPPD was evaluated following the clinical approaches validated for this diagnostic. The monitoring, the medications ( bupivacaina 0,5% ,10 mg+25 µg fentanyl ) and the needle type (25G of Q), they were standardized for the two groups. Results: The position DLI was effective to diminish the incidence of CPPD in 45% reducing its incidence of 28,73% in seated position to 15,62% in DLI, with a relative risk of 0,54 (IC95% 0,31-0,96 p=0,0321). The predictor model demonstrated that not alone the position but the anesthesiologist's experience added to the success in the first attempts, also behaves as protective factor for CPDD, with RR 0,45 (IC:95% 0,26 - 0,76) p=0,003. Conclusions: The obstetic population subjected to caesarean section, under spinal anesthesia in DL presents minor risk of CPPD, when it is compared equal anesthesia technique carried out in seated position.

Keywords : postdural puncture headache; spinal anesthesia; obstetrics; caesarean section; controlled clinical trial.

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