国际麻醉学与复苏杂志   2024, Issue (4): 0-0
    
《硬脊膜穿破后头痛的国际多学科共识实践指南》解读
吴奇, 廖兴志, 薄禄龙, 邓小明1()
1.上海长海医院
Interpretation of the international multidisciplinary consensus and practice guidelines on postdural puncture headache
 全文:
摘要:

硬脊膜穿破后头痛(postdural puncture headache, PDPH)是硬脊膜外操作时意外刺破硬脊膜、进行脊髓麻醉、诊断性或介入性椎管内操作时出现的一种并发症。鉴于既往预防和治疗PDPH的综述大多缺乏结构化建议,美国区域麻醉和疼痛医学会等6个学术团体于2023年8月发布《硬脊膜穿破后头痛的国际多学科共识实践指南》,涉及PDPH预防、诊断和治疗的10个问题,共形成47个建议和37个声明,是一份较为全面的循证指南。文章对指南要点进行摘译和解读,以期增加麻醉医师对PDPH预防和管理新策略的认识。

关键词: 硬脊膜穿破后头痛; 并发症; 椎管内麻醉; 脑脊液漏; 指南
Abstract:

Postdural puncture headache (PDPH) is a complication following unintentional dural puncture during epidural analgesia, or intentional dural puncture during spinal anesthesia, diagnostic or interventional neuraxial procedures. Due to the lack of structured recommendations in previous reviews on the prevention and treatment of PDPH, in August 2023, six academic societies including the American Society of Regional Anesthesia and Pain Medicine released the “Consensus practice guidelines on postdural puncture headache from a multisociety, international working group”. This evidence‑based guideline provides a comprehensive overview, and address 10 questions regarding the prevention, diagnosis, and treatment of PDPH, resulting in 47 recommendations and 37 statements. This review aims to summarize and interpret the key points of the guidelines, in order to increase awareness among anesthesiologists about new strategies for PDPH prevention and management in China.

Key words: Postdural puncture headache; Complication; Intraspinal anesthesia; Cerebrospinal fluid leakage; Guidelines