مقایسه دو روش مدین و پارامدین بر میزان بروز سردرد پس از بیحسی نخاعی در زنان تحت بیحسی اسپاینال: یک مطالعه مرور نظامند

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 دانشیار 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 متخصص بیهوشی و مراقبتهای ویژه، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

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

چکیده

مقدمه: سردرد پس از بی­ حسی نخاعی، یک مشکل شایع در زنان باردار تحت سزارین با بی­ حسی نخاعی می­ باشد. از بین روش­ های بی­ حسی ناحیه‌ای، بی­ حسی نخاعی یکی از رایج ­ترین روش­ ها جهت اعمال سزارین می­ باشد که عمدتاً با دو تکنیک مدین و پارامدین انجام می­ شود. بنابراین مطالعه حاضر با هدف مقایسه دو روش مدین و پارامدین بر میزان بروز سردرد پس از بی­ حسی نخاعی در زنان تحت بی ­حسی اسپاینال به‌صورت یک مطالعه مرور نظامند انجام گرفت.
روشکار: در این مطالعه مرور نظامند جهت یافتن مقالات مرتبط، پایگاه­ های اطلاعاتی Scopus، PubMed، Magiran، SID، Medlib، Cochrane، Science Direct و موتور جستجوگر Google Scholar با کلید واژه‌های فارسی مدین، پارامدین، سردرد پس از بی­ حسی نخاعی، سزارین، بی­ حسی اسپاینال و کلید واژه‌های انگلیسی Median، Paramedian، PDPH، Cesarean Section، Spinal Anesthesia به دو زبان فارسی و انگلیسی، بدون محدودیت زمانی تا تاریخ 20 اردیبهشت 1402 جستجو شدند. جهت ارزیابی کیفی مقالات از چک‌لیست جداد استفاده شد.
یافته ­ها: مطالعات وارد شده در مرور سیستماتیک شامل 11 مطالعه و محدوده انجام مطالعات بین سال ­های 2021-2009 بود. در مجموع 1195 بیمار با کلاس بیهوشی 1 و 2 وارد مطالعه شدند. در 4 مطالعه بین دو رویکرد مدین و پارامدین هیچ تفاوت آماری معنی‌داری بین دو گروه وجود نداشت. در 6 مطالعه روش پارامدین باعث بروز سردرد کمتر نسبت به مدین و در 1 مطالعه روش مدین باعث بروز سردرد کمتر نسبت به پارامدین شده بود.
نتیجه­ گیری: استفاده از روش پارامدین نسبت به تکنیک مدین می ­تواند باعث بروز کمتر سردرد پس از بی­حسی نخاعی بعد از عمل جراحی سزارین شود. پیشنهاد می­ شود متخصصین بیهوشی در صورت امکان از تکنیک پارامدین جهت بی­ حسی اسپاینال برای زنان تحت عمل جراحی سزارین استفاده کنند تا از بروز سردرد پس از بی­ حسی نخاعی بعد از عمل جراحی در این بیماران جلوگیری یا کاهش دهند.

کلیدواژه‌ها


عنوان مقاله [English]

Median versus paramedian methods on the incidence of postdural puncture headache in women under spinal anesthesia: a systematic review

نویسندگان [English]

  • Pourya Adibi 1
  • Reza Sahraei 2
  • Majid Vatankhah 3
  • Bibi Mona Razavi 1
  • Tayyebeh Zarei 1
  • Samira Zanbagh 1
  • Elahe Rahmanian 4
  • Somayeh Mehrpour 5
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 Associate Professor, 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 Anesthesiologist and Special Care specialist, Anesthesiology, Critical Care and Pain Management Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Qom University of medical sciences, Qom, Iran.
چکیده [English]

Introduction: Headache after spinal anesthesia is a common problem in pregnant women undergoing cesarean section with spinal anesthesia. Among the regional anesthesia methods, spinal anesthesia is one of the most common methods for cesarean section, which is mainly performed with median and paramedian techniques. Therefore, this systematic review study was conducted with aim to compare two methods of median and paramedian on the incidence of postdural puncture headache (PDPH ) in women under spinal anesthesia.
Methods: In this systematic review study, to find the related articles, Scopus, PubMed, Magiran, SID, Medlib, Cochrane, Science Direct databases and Google Scholar search engine were searched using the keywords of median, paramedian, postdural puncture headache, caesarean section, and spinal anesthesia in both Persian and English languages without time limit until 20 May 2023. Jadad checklist was used to evaluate the quality of the articles.
Results: The studies entered in the systematic review included 11 studies and the studies were conducted in 2009-2021. A total of 1195 patients with anesthesia class 1 and 2 were included in the study. In 4 studies, there was no statistically significant difference between the two groups of median and paramedian approaches. In 6 studies, the paramedian method caused fewer headaches than median method. In one study, median method caused fewer headaches than paramedian method.
Conclusion: The use of the paramedian method compared to the median technique can cause a lower incidence of PDPH after cesarean surgery. It is suggested that anesthesiologists use the paramedian technique for spinal anesthesia for women undergoing cesarean surgery, if possible, in order to prevent or reduce the occurrence of PDPH after surgery in these patients.

کلیدواژه‌ها [English]

  • Headache
  • Median
  • Paramedian
  • Spinal anesthesia
  1. Motaghi K, Safari F, Khodabendelou L, Salimi A. Evaluation the efficacy of IV dexamethasone on post puncture headache incidence after cesarian section. Anesthesiology and Pain 2011; 2(2):34-40.
  2. Turnbull DK, Shepherd DB. Post‐dural puncture headache: pathogenesis, prevention and treatment. British journal of anaesthesia 2003; 91(5):718-29.
  3. Najafi A, Emami S, Khajavi M, Etezadi F, Imani F, Lajevardi M, et al. Is epidural dexamethasone effective in preventing postdural puncture headache?. Acta Anaesthesiologica Taiwanica 2014; 52(3):95-100.
  4. Basurto Ona X, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for treating post-dural puncture headache. Cochrane Database Syst Rev 2011; (8):CD007887.
  5. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL. Miller's anesthesia e-book. 8nd Elsevier Health Sciences; 2014.
  6. Lybecker H, Møller JT, May O, Nielsen HK. Incidence and prediction of postdural puncture headache A prospective study of 1021 spinal anesthesias. Anesthesia & Analgesia 1990; 70(4):389-94.
  7. Halpern S, Preston R. Postdural puncture headache and spinal needle design. Metaanalyses. Anesthesiology 1994; 81(6):1376-83.
  8. Ross BK, Benedetti C, Chadwick HS, Mancuso JJ. Sprotte needle for obstetric anesthesia: decreased incidence of post dural puncture headache. Regional Anesthesia: The Journal of Neural Blockade in Obstetrics, Surgery, & Pain Control 1992; 17(1):29-33.
  9. Tarkkila PJ, Heine H, Tervo RR. Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache. Regional Anesthesia and Pain Medicine 1992; 17(5):283-7.
  10. Janik R, Dick W. Post spinal headache. Its incidence following the median and paramedian techniques. Der Anaesthesist 1992; 41(3):137-41.
  11. Naulty JS, Hertwig L, Hunt CO, Datta S, Ostheimer GW, Weiss JB. Influence of local anesthetic solution on postdural puncture headache. Anesthesiology 1990; 72(3):450-4.
  12. SM S. Anesthesia for cesarean section. Anesthesia for obstetrics 1993: 211-45.
  13. Miller R, Johns R, Savarese J, Wiener-Kronish J, Young W. Miller’s Anesthesia. 7nd Philadelphia: Elsevier Company; 2010.
  14. Blomberg RG, Jaanivald A, Walther S. Advantages of the paramedian approach for lumbar epidural analgesia with catheter technique: a clinical comparison between midline and paramedian approaches. Anaesthesia 1989; 44(9):742-6.
  15. Safa-Tisseront V, Thormann F, Malassiné P, Henry M, Riou B, Coriat P, et al. Effectiveness of epidural blood patch in the management of post–dural puncture headache. The Journal of the American Society of Anesthesiologists 2001; 95(2):334-9.
  16. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled clinical trials 1996; 17(1):1-12.
  17. Karami T, Karami N, Rastgo H. Comparison of the effect of paramedian and median methods on postdural puncture headache among candidates for elective ce-sarean sections undergoing spinal anesthesia. A double blind. Pediatric Anesthesia and Critical Care Journal 2021; 9(2):116-122.
  18. Mohamed ZE, Selim MF. Rationale of modified paraspinous/paramedian technique for spinal anesthesia in prevention of post dural puncture headache after cesarean section. Anaesthesia, Pain & Intensive Care 2021; 25(4):487-93.
  19. Uluer MS, Sargin M, Akin F, Uluer E, Şahin O. A randomized study to evaluate post-dural puncture headache after cesarean section: Comparison with median and paramedian approaches. Nigerian journal of clinical practice 2019; 22(11):1564-9.
  20. Gurulingaswamy Sh, Ramegowda DS, MCB S, Iyyappan A. Postdural Puncture Headache: A Comparison between Median and Paramedian Approach under Spinal Anesthesia in Cesarean Section. Indian Journal of Anesthesia and Analgesia 2019; 6(6):2241-48.
  21. Bansal T, Vashisht G, Sharma R. A study to compare median versus paramedian approach regarding incidence of postdural puncture headache under spinal anesthesia in cesarean section. InThe Indian Anaesthetists Forum 2018; 19(2):61-64.
  22. Firdous T, Siddiqui MA, Siddiqui SM. Frequency of post dural puncture headache in patients undergoing elective cesarean section under spinal anesthesia with median versus paramedian approach. Anaesthesia, Pain & Intensive Care 2019: 165-70.
  23. Nisar A, Saleem J, Hussain S, Bashir K. Comparison of postdural puncture headache in median and paramedian approach under spinal anesthesia in cesarean section. Pak J Med Health Sci 2016; 10(1):298-301.
  24. Behery MA, Elshahat M. Post Dural Lumbar Puncture Headache (Pdph) after Spinal Anesthesia for Cesarean Section,Comparative Study Between Para Median and Median Approaches. Al-Azhar Assiut Medical Journal 2015; 13(2):103-110.
  25. Pourbahri M, Kashani S, Malekshoar M, Jarineshin H, Vatankhah M, Baghaee AA, et al. Comparison of median vs. paramedian techniques of spinal anesthesia in cesarean section. Anesthesiology and Pain 2015; 6(3):9-20.
  26. Sadeghi A, Razavi SJ, Gachkar L, Mariana P, Ghahremani M. Comparison the incidence of post spinal headache following median and paramedian approach in ceasarean patients. Journal of Iranian Society of Anaesthesiology and Intensive Care 2009; 31(67):4-9.
  27. Li JY, Tsai SC, Wang CH, Hui YL, Tan PC. Paramedian Approach Reduce the Incidence of post dural puncture headache. Chinese J Pain 1995; 5:71-6.
  28. Nofal WH, Mahmoud MS, Abd Al Alim AA. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?. Saudi Journal of Anaesthesia 2014; 8(3):359-63.
  29. Patel N. Anesthesia for cesarean delivery. Journal of Advanced Medical and Dental Sciences Research 2015; 3(4):25-9.
  30. Zabetian H, Rahmanian M, Tadayon N, Kalani N. Comparison of pain with bupivacaine and bupivacainesufentanil combination in women undergoing cesarean section with spinal anesthesia: A double-blind randomized clinical trial. Iran J Obstet Gynecol Infertil 2022; 25(8):8-18.
  31. Adibi P, Kalani N, Razavi BM, Mehrpour S, Zarei T, Malekshoar M, et al. Pharmacological and non-pharmacological methods of pain control in women undergoing caesarean section: a narrative review. Iran J Obstet Gynecol Infertil 2022; 25(7):91-112.
  32. Zabetian H, Rahmanian M, Damshenas MH, Rastgarian A, Nabipour M, Hatami N, et al. The effect of adding pethidine to bupivacaine 0.5% and ropivacaine 0.5% on pain intensity in women undergoing elective cesarean section with spinal anesthesia: A double-blind randomized clinical trial study. Iran J Obstet Gynecol Infertil 2022; 25(2):1-12.
  33. Dyer RA, Piercy JL, Reed AR, Lombard CJ, Schoeman LK, James MF. Hemodynamic changes associated with spinal anesthesia for cesarean delivery in severe preeclampsia. The Journal of the American Society of Anesthesiologists 2008; 108(5):802-11.
  34. Afolabi BB, Lesi FE. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev 2012; 10:CD004350.
  35. Miller RD, Pardo M. Basics of anesthesia e-book. 6nd New York: Elsevier Health Sciences; 2011.
  36. Malekshoar M, Vatankhah M, Rasekh Jahromi A, Ghasemloo H, Mogharab F, Ghaedi M, et al. Shivering control in women under spinal anesthesia: A narrative review on the role of drugs. Iran J Obstet Gynecol Infertil 2021; 24(7):61-9.
  37. Ghasemloo H, Sadeghi SE, Jarineshin H, Rastgarian A, Taheri L, Rasekh Jahromi A, et al. Control of nausea and vomiting in women undergoing cesarean section with spinal anesthesia: A narrative review study on the role of drugs. Iran J Obstet Gynecol Infertil 2021; 24(7):98-107.
  38. Adibi P, Kalani N, Vatankhah M, Razavi BM, Mehrpour S, Zarei T, et al. Treatment OF Post dural puncture headache (PDPH) after caesarean section: a review of clinical trial articles conducted in Iran. Iran J Obstet Gynecol Infertil 2022; 25(10):94-106.
  39. Adams HA, Meyer P, Stoppa A, Müller-Goch A, Bayer P, Hecker H. Anästhesie zur Sectio caesarea. Ein Vergleich von zwei Verfahren der Allgemeinanästhesie sowie der Spinalanästhesie [Anaesthesia for caesarean section. Comparison of two general anaesthetic regimens and spinal anaesthesia]. Anaesthesist 2003; 52(1):23-32.
  40. Eltzschig HK, Lieberman ES, Camann WR. Regional anesthesia and analgesia for labor and delivery. New England Journal of Medicine 2003; 348(4):319-32.
  41. Madineh H, Abedinzadeh MR, Gaheri H. Comparison of post cesarean section pain with general and spinal anesthesia. Journal of Shahrekord Uuniversity of Medical Sciences 2005; 6(4):43-50.
  42. Vaquero Roncero LM, Sánchez Montero FJ, Muriel Villoria C. Eficacia de la administración peridural de soluciones salinas isotónicas en la profilaxis y tratamiento de las cefaleas postpunción dural [Effectiveness of epidural administration of saline solutions to prevent or treat postdural puncture headache]. Rev Esp Anestesiol Reanim 2004; 51(10):589-94.
  43. Ghaleb A. Postdural puncture headache. Anesthesiology research and practice 2010; 2010.
  44. Vilming ST, Kloster R. Pain location and associated symptoms in post-lumbar puncture headache. Cephalalgia 1998; 18(10):697-703.
  45. Khlebtovsky A, Weitzen S, Steiner I, Kuritzky A, Djaldetti R, Yust-Katz S. Risk factors for post lumbar puncture headache. Clinical neurology and neurosurgery 2015; 131:78-81.
  46. Amorim JA, Gomes de Barros MV, Valença MM. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia 2012; 32(12):916-23.
  47. Wadud R, Laiq N, Qureshi FA, Jan AS. The frequency of postdural puncture headache in different age groups. Journal of the College of Physicians and Surgeons--pakistan: JCPSP 2006; 16(6):389-92.
  48. Evans RW, Armon C, Frohman EM, Goodin DS. Assessment: Prevention of post–lumbar puncture headaches: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2000; 55(7):909-14.
  49. Leibold RA, Yealy DM, Coppola M, Cantees KK. Post-dural-puncture headache: characteristics, management, and prevention. Annals of emergency medicine 1993; 22(12):1863-70.
  50. Mosaffa F, Karimi K, Madadi F, Khoshnevis SH, Besheli LD, Eajazi A. Post-dural puncture headache: A comparison between median and paramedian approaches in orthopedic patients. Anesthesiology and Pain Medicine 2011; 1(2):66-9.
  51. Pourmokhtari M, Pourhashemi A, Kalani N. Comparison of Medin and Parmadin methods in incidence Post-Dural-puncture headache (PDPH) in patients undergoing orthopedic lower extremity surgery by spinal anesthesia. Pars Journal of Medical Sciences 2023; 20(4):47-56.
  52. Jahromi MS, Zabetian H, Kalani N, Khosravani F, Yousefi A. Comparing the Incidence of Postdural Puncture Headache (PDPH) between Median and Paramedian Approaches in Nephrolithotripsy under Spinal Anesthesia. International Journal of Medical Investigation 2023; 12(1):83-91.
  53. Bharat Ramchandra Sonawane, Arti Jagdish Patil. Comparative study of postdural puncture headache in midline and paramedian approach of spinal anaesthesia at a tertiary hospital. MedPulse International Journal of Anesthesiology. December 2020; 16(3):144-147.
  54. Butt MR, Javed HM, Ashfaq MA, Zahid MM, Iqbal A, Khalid M. Comparison of Incidence of Post-Dural Puncture Headache in Patients Undergoing Spinal Anesthesia Following Median VS Paramedian Approach. Biological and Clinical Sciences Research Journal 2023; 2023(1):338.
  55. Suttiponopas C. Comparison of Midline and Paramedian Approach Technique of Spinal Anesthesia for Caesarean Section 2018; 11(2): 131-135.
  56. Haider S, Butt KJ, Aziz M, Qasim M. Post dural puncture headache-a comparison of midline and paramedian approaches. Biomedica 2005; 21(July-December):90-2.
  57. Janik R, Dick W. Post spinal headache. Its incidence following the median and paramedian techniques. Der Anaesthesist 1992; 41(3):137-41.
  58. Ahsan-ul-Haq M, Amin S, Javaid S. Paramedian technique of spinal anesthesia in elderly patients for hip fracture surgery. Journal of the College of Physicians and Surgeons--pakistan: JCPSP 2005; 15(3):160-1.
  59. Muranaka K, Mizutani H, Seo K, Yoshida M, Gohara T, Miyawaki H. A comparison between midline and paramedian approaches for combined spinal-epidural anesthesia. Masui. The Japanese Journal of Anesthesiology 2001; 50(10):1085-8.
  60. Choi PT. Management of postdural puncture headache. Techniques in Regional Anesthesia and Pain Management 2001; 5(1):41-5.
  61. Kwak KH. Postdural puncture headache. Korean journal of anesthesiology 2017; 70(2):136-43.