Mustafa Kemal YILDIRIM, Haci Ömer OSMANLIOĞLU, Berit GÖKÇE CEYLAN, Füsun EROĞLU

25G, 27G ve 29G Quincke İğneler ile Spinal Anestezi Uygulanan Sezaryen Hastalarında Postoperatif Baş Ağrısı Sıklığı ve Şiddetinin Karşılaştırılması.

ÖZET25G, 27G ve 29G Quincke İğneler ile Spinal Anestezi Uygulanan Sezaryen Hastalarında Postoperatif Baş Ağrısı Sıklığı ve Şiddetinin Karşılaştırılması. Amaç: Bu çalışmanın amacı 25G, 27G ve 29G quincke iğneler ile spinal anestezi uygulan sezaryen hastalarında ameliyat sonrası spinal anesteziye bağlı gelişen baş ağrısı sıklığını ve şiddetini karşılaştırmak. Gereç ve Yöntem: SDÜ Tıp Fakültesi Klinik Araştırmalar Yerel Etik Kurulunun onayı alındıktan sonra, ASA I-II, 18 yaş üzeri elektif sezaryen cerrahisi planlanan 60 hasta çalışmaya alındı. Hastalar randomize olarak 3 gruba ayrıldı. Grup I hastalara (n=20) 25G, Grup II hastalara (n=20) 27G, Grup III hastalara (n=20) 29G (kılavuzlu) quincke keskin uç iğneler kullanılarak spinal anestezi uygulandı. Spinal anestezi başarısız veya yetersiz olan hastalarda genel anesteziye geçildi ve hastalar çalışma dışı bırakıldı. Hastalarda baş ağrısı gelişip gelişmediği, ağrının süresi ve şiddeti 2. haftaya kadar gerekirse telefonla hastalara dönüş yapılarak sorgulandı ve kayıt altına alındı. Baş ağrısı şiddeti Lybecker sınıflamasına göre derecelendirildi. Bulgular: Toplamda 60 hastanın 9' unda (15,0 %) postdural ponksiyon santral baş ağrısı (PDPBA) oluştu. Grupların kendi içinde dağılımı; Grup I' de 20 hastanın 5' inde (25.0 %), Grup II' de 20 hastanın 3' ünde (15.0%), Grup III' de 20 hastanın 1' inde (5.0%) PDPBA oluştu. Grup I' de 2 hastada şiddetli baş ağrısı olurken Grup II ve Grup III' de şiddetli baş ağrısı olmamıştır. Gruplar arasında PDPBA insidansı açısından istatiksel olarak anlamlı bir fark bulunmadı. Sonuç: Farklı iğne boyutları arasında istatistik olarak fark bulunmasa da PDPBA riskini en azından önlemek için eğer elde edilebiliyor ise klinik pratikte 29 G kılavuzlu keskin uçlu iğne tercih edilebilir.

Anahtar Kelimeler:

Sezaryen, Spinal anestezi, Baş ağrısı

The Comparison of Postoperative Headache Frequency and Severity on Sectio Patients that Spinal Anaesthesia Performed with 25G, 27G and 29G Quincke Needles

ABSTRACTThe Comparison of Postoperative Headache Frequency and Severity on Sectio Patients that Spinal Anaesthesia Performed with 25G, 27G and 29G Quincke Needles Aim: The aim of this study is to compare the frequency and severity of post spinal headache between the sectio patients that was spinal anaesthesia performed with 25G, 27G and 29G quincke needles. Materials and Methods: Following the approval of Clinical researches local Ethics Committee of Suleyman Demirel University 60 ASA I-II clinical status patients above 18 years that sectio operation was planned included in the study. Patients were ramdomised to three groups. The spinal anaesthesai was performed with 25G guided quincke sharp-tipped needle to Group I (n=20), with 27G needle in Group II (n=20) and with 29G needle in Group III (n=25). General anesthesia was performed in unsuccessful spinal anaesthesia patients and they were excluded from the study. The headache, the time and the severity till the second week of the operation and was asked and reported .The severity was degreed according to Lybecker classification. Results: Postdural central headache was reported on 9 of total 60 patients (15,0 %). The distribution was as : 5 patients in Group I (25.0 %), 3 patients in Group II (15.0 %), and 1 patient in Group III (5.0%). Severe headache was occurred in 2 patients in Group I and was not occurred in any patients in Group II and III. There was no significany difference istatistically between groups by the means of postdural puncture headache. Conclusion: At least for preventing the risk, although there is no statistically difference between different needle sizes; we think that 29G guided needle may be preferred in the clinical practice if available.

Keywords:

Sectio, Spinal anaesthesia, Headache,

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