درمان سردرد پس از بی‌حسی نخاعی بعد از عمل جراحی سزارین: مرور روایتی بر مقالات کارآزمایی بالینی انجام شده در ایران

نوع مقاله : مروری

نویسندگان

1 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی، مراقبت ویژه و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

2 مربی گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی، مراقبت ویژه و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

4 استادیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی قم، قم، ایران.

5 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

6 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

چکیده

مقدمه: سردرد، یکی از مشکلات شایع پس از بی­ حسی نخاعی بعد از عمل جراحی سزارین می­ باشد. روش ­های مختلف دارویی مختلفی برای درمان سردرد پس از بی­ حسی نخاعی پیشنهاد شده است. مطالعه حاضر با هدف بررسی سردرد پس از بی­ حسی نخاعی بعد از عمل جراحی سزارین، به‌صورت مرور روایتی بر مقالات کارآزمایی بالینی انجام شده در ایران صورت گرفت.
روش‌کار: در این مطالعه مروری نقلی (روایتی) جهت یافتن مقالات مرتبط، پایگاه­ های اطلاعاتی فارسی زبان SID، Magiran و موتور جستجوگر Google Scholar با کلید واژگان فارسی شامل: سردرد، بی‌حسی نخاعی و سزارین و پایگاه ­های انگلیسی زبان PubMed، Web of Science وScopus  با کلید واژگان PDPH،Spinal Anesthesia وCesarean section  بدون محدودیت بازه زمانی مورد جستجو قرار گرفتند.
یافته­ ها: در این مطالعه مروری نقلی، 29 مقاله مورد بررسی قرار گرفت. مطالعات جستجو شده در بازه زمانی بین سال‌های 2022-2007 بود. داروهای مورد بررسی شامل: پره‌گابالین، گاباپنتین، تئوفیلین، اندانسترون، آمینوفیلین، دگزامتازون، کافئین، مانیتول، استامینوفن وریدی (پاراستامول)، نرمال سالین، پروپوفول و هیدروکورتیزون بود. از بین داروهای مورد بررسی، دگزامتازون بیشترین اثربخشی را در کنترل PDPH و بعد از آن اندانسترون بیشترین اثر را بر روی کاهش و کنترل PDPH داشته است.
نتیجه­ گیری: مطالعه حاضر شواهد مناسبی در زمینه مؤثر بودن داروهای مورد بررسی در مطالعات را نشان داد. به‌‌نظر می ­رسد تمامی داروهای مورد بررسی را بتوان به‌‌عنوان درمان سردرد پس از بی­ حسی نخاعی در زنان تحت عمل جراحی سزارین استفاده نمود؛ با این حال از بین داروهای مورد بررسی با توجه به اینکه در مورد داروی دگزامتازون مطالعات بیشتری نسبت به سایر مطالعات صورت گرفته است و همچنین اثربخشی بیشتری در مطالعات داشته است، به‌نظر می­ رسد می­ تواند انتخاب مناسب‌تری برای پیشگیری از سردرد پس از بی­ حسی نخاعی در زنان سزارینی باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Treatment OF Post dural puncture headache (PDPH) after caesarean section: a review of clinical trial articles conducted in Iran

نویسندگان [English]

  • Pourya Adibi 1
  • Navid Kalani 2
  • Majid Vatankhah 3
  • Bibi Mona Razavi 1
  • Somayeh Mehrpour 4
  • Tayyebeh Zarei 1
  • Hasan Zabetian 5
  • Elahe Rahmanian 6
1 Assistant professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2 Instructor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Associate Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
4 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Qom University of medical sciences, Qom, Iran.
5 Associate Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
6 Assistant Professor, Department of Anesthesiology, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Introduction: Headache is one of the common problems after spinal anesthesia following cesarean surgery. Various pharmacological methods have been proposed for the treatment of headache after spinal anesthesia. This study was conducted with aim to evaluate headache after spinal anesthesia following caesarean section in the form of a narrative review of clinical trial articles conducted in Iran.
Methods: In this narrative review study, to find related studies, the Persian language databases of "SID", "Magiran" and the Google Scholar and English language databases of Scopus, PubMed, and Web of Science were searched with the keywords of PDPH, spinal anesthesia and cesarean section wiyhout time limitation.
Results: In this narrative review study, 29 articles were examined. The reviewed studies were done from 2007-2022. The investigated drugs include: Pregabalin, gabapentin, theophylline, ondansetron, aminophylline, dexamethasone, caffeine, mannitol, intravenous acetaminophen (paracetamol), normal saline, propofol and hydrocortisone. Among the investigated drugs, dexamethasone has been most effective in controlling PDPH, and then, ondansetron has been most effective in reducing and controlling PDPH.
Conclusion: The present study showed good evidence on the effectiveness of the drugs investigated in the studies. It seems that all the investigated drugs can be used as a treatment for headache (PDPH) after spinal anesthesia in cesarean section women; however, among the investigated drugs, since more studies have been performed on dexamethasone, it can be a more suitable choice for preventing headache after spinal anesthesia in cesarean section women.

کلیدواژه‌ها [English]

  • Cesarean Section
  • Iran
  • Narrative review
  • PDPH
  • Spinal anesthesia

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 10
دی 1401
صفحه 94-106

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