Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia

Kyu Chang Lee; Dae-Jeong Koo; Won Sang Lee; Hye Young Kim; Yusun Choi; Myeong Jong Lee

doi:doi:10.11648/j.ja.20150304.11

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Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia

Kyu Chang Lee, Dae-Jeong Koo, Won Sang Lee, Hye Young Kim, Yusun Choi, Myeong Jong Lee

Published in Journal of Anesthesiology (Volume 3, Issue 4)

Received: 26 August 2015 Accepted: 21 September 2015 Published: 12 October 2015

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Abstract

Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.

Published in	Journal of Anesthesiology (Volume 3, Issue 4)
DOI	10.11648/j.ja.20150304.11
Page(s)	14-16
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

CSF Leakage, Epidural Blood Patch, Hydrostatic Pressure, Postdural Puncture Headache, Saddle Anesthesia, Sitting Position

References

[1]	Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail's Clinical anesthesiology. 5^th ed. New York, McGraw-Hill Companies, Inc. 2013, pp 969-70.
[2]	Kuzman T, Jurjević I, Mandac I, Radoš M, Orešković D, Jednačak H, et al. The effect of body position on intraocular and CSF pressures in the lateral ventricle, and in cortical and lumbar subarachnoid spaces in cats. Acta Neurochir Suppl 2012; 114: 357-61.
[3]	Shah JL. Epidural pressure and postdural puncture headache in the parturient. Int J Obstet Anesth 1993; 2: 187-9.
[4]	Miller RD, Eriksson LI, Fleisher LA, Wiener-Krenish JP, Young WL. Miller's Anesthesia. 7^th ed. Philadelphia, Churchill Livingstone.2010, pp 1626-7.
[5]	Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC. Clinical anesthesia. 6^th ed. Philadelphia, Lippincott. 2009, 583-4.
[6]	Lybecker H, Djernes M, Schmidt TF. Postdural puncture headache (PDPH): Onset, duration, severity, and associated symptoms An analysis of 75 consecutive patients with PDPH. Acta Anaesthesiol Scand 1995; 39: 605-12.
[7]	Jones RJ. The role of recumbency in the prevention and treatment of postspinal headache. Anesth Analg 1974; 53: 788-796.
[8]	Carbaat PA, van Crevel H. Lumbar puncture headache: controlled study on the preventive effect of 24 hours’ bed rest. Lancet 1981; 2: 1133-1135.
[9]	Tejavanija S, Sithinamsuwan P, Sithinamsuwan N, Nidhinandana S, Suwantamee J. Comparison of prevalence of post-dural puncture headache between six hour-supine recumbence and early ambulation after lumbar puncture in thai patients: A randomized controlled study. J Med Assoc Thai 2006; 89: 814-20.
[10]	Schmittner MD, Urban N, Janke A, Weiss C, Bussen DG, Burmeister MA et al. Influence of the pre-operative time in upright sitting position and the needle type on the incidence of post-dural puncture headache (PDPH) in patients receiving a spinal saddle block for anorectal surgery. Int J Colorectal Dis 2011; 26: 97-102.

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APA Style

Kyu Chang Lee, Dae-Jeong Koo, Won Sang Lee, Hye Young Kim, Yusun Choi, et al. (2015). Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 3(4), 14-16. https://doi.org/10.11648/j.ja.20150304.11

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ACS Style

Kyu Chang Lee; Dae-Jeong Koo; Won Sang Lee; Hye Young Kim; Yusun Choi, et al. Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. Int. J. Anesth. Clin. Med. 2015, 3(4), 14-16. doi: 10.11648/j.ja.20150304.11

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AMA Style

Kyu Chang Lee, Dae-Jeong Koo, Won Sang Lee, Hye Young Kim, Yusun Choi, et al. Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. Int J Anesth Clin Med. 2015;3(4):14-16. doi: 10.11648/j.ja.20150304.11

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@article{10.11648/j.ja.20150304.11,
  author = {Kyu Chang Lee and Dae-Jeong Koo and Won Sang Lee and Hye Young Kim and Yusun Choi and Myeong Jong Lee},
  title = {Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {3},
  number = {4},
  pages = {14-16},
  doi = {10.11648/j.ja.20150304.11},
  url = {https://doi.org/10.11648/j.ja.20150304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20150304.11},
  abstract = {Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.},
 year = {2015}
}

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TY  - JOUR
T1  - Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia
AU  - Kyu Chang Lee
AU  - Dae-Jeong Koo
AU  - Won Sang Lee
AU  - Hye Young Kim
AU  - Yusun Choi
AU  - Myeong Jong Lee
Y1  - 2015/10/12
PY  - 2015
N1  - https://doi.org/10.11648/j.ja.20150304.11
DO  - 10.11648/j.ja.20150304.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 14
EP  - 16
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20150304.11
AB  - Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.
VL  - 3
IS  - 4
ER  -

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Author Information

Kyu Chang Lee

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea
Dae-Jeong Koo

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea
Won Sang Lee

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea
Hye Young Kim

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea
Yusun Choi

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea
Myeong Jong Lee

Department of Anesthesiology and Pain Medicine, Konkuk University Medical School, Chungju, Korea

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APA Style

Kyu Chang Lee, Dae-Jeong Koo, Won Sang Lee, Hye Young Kim, Yusun Choi, et al. (2015). Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 3(4), 14-16. https://doi.org/10.11648/j.ja.20150304.11

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ACS Style

Kyu Chang Lee; Dae-Jeong Koo; Won Sang Lee; Hye Young Kim; Yusun Choi, et al. Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. Int. J. Anesth. Clin. Med. 2015, 3(4), 14-16. doi: 10.11648/j.ja.20150304.11

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AMA Style

Kyu Chang Lee, Dae-Jeong Koo, Won Sang Lee, Hye Young Kim, Yusun Choi, et al. Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia. Int J Anesth Clin Med. 2015;3(4):14-16. doi: 10.11648/j.ja.20150304.11

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@article{10.11648/j.ja.20150304.11,
  author = {Kyu Chang Lee and Dae-Jeong Koo and Won Sang Lee and Hye Young Kim and Yusun Choi and Myeong Jong Lee},
  title = {Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {3},
  number = {4},
  pages = {14-16},
  doi = {10.11648/j.ja.20150304.11},
  url = {https://doi.org/10.11648/j.ja.20150304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20150304.11},
  abstract = {Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.},
 year = {2015}
}

Copy | Download

TY  - JOUR
T1  - Evaluation of Incidence of Post-Dural Puncture Headache with Maintenance of Sitting Position Immediately After Spinal Anesthesia
AU  - Kyu Chang Lee
AU  - Dae-Jeong Koo
AU  - Won Sang Lee
AU  - Hye Young Kim
AU  - Yusun Choi
AU  - Myeong Jong Lee
Y1  - 2015/10/12
PY  - 2015
N1  - https://doi.org/10.11648/j.ja.20150304.11
DO  - 10.11648/j.ja.20150304.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 14
EP  - 16
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20150304.11
AB  - Background: In spinal saddle anesthesia, maintaining the sitting position for 3–5 min, to allow for the descent of the injected drug after lumbar dural puncture, minimizes side effects such as blood pressure reduction. However, it also increases cerebrospinal fluid leakage due to the hydrostatic pressure. We investigated the effects of the maintenance of the sitting position after spinal anesthesia on the development of postdural puncture headache (PDPH). Methods: We reviewed all data of patients undergoing spinal anesthesia performed between January 1, 2012 and December 31, 2013 retrospectively. The incidence of PDPH and epidural blood patch administration were investigated after grouping patients into two groups: the SP group (patients were laid down immediately after spinal anesthesia) and the SA group (patients were maintained in the sitting position for 3–5 min before changing to the operating position). Results: There were no cases of severe PDPH or epidural blood patch administration in the SP group. In the SA group, there were four cases (4%) of PDPH, and among these, three cases (3%) required epidural blood patch administration. Conclusions: The maintenance of the sitting position after spinal anesthesia caused a persistent increase in the transdural pressure, resulting in a higher incidence of PDPH compared with patients that were laid down immediately after anesthesia.
VL  - 3
IS  - 4
ER  -

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