Prevenção e Tratamento da Cefaleia Pós-Raquianestesia: uma revisão integrativa
Prevenção e Tratamento da Cefaleia Pós-Raquianestesia: uma revisão integrativa
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DOI: https://doi.org/10.22533/at.ed.8421625120614
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Palavras-chave: Anestesia; Cefaleia Pós-Punção Dural; Terapêutica.
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Keywords: Anesthesia; Post-Dural Puncture Headache; Therapeutics.
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Abstract: Spinal anesthesia is a simple anesthetic technique, which consists of injecting an anesthetic solution into the subarachnoid space, causing a conduction block. The most common symptom is post-dural puncture headache (PDPH), which can appear hours after surgery and disappear spontaneously or with drug treatment. Prophylactic measures and treatment are still being studied. Therefore, the objective of this study was to evaluate the most effective prevention and treatment measures for post-spinal anesthesia headache. A search was carried out on the National Library of Medicine (PubMed) and Regional Portal of the Virtual Health Library (VHL) platforms and a total of 22 scientific articles were selected after applying the inclusion criteria, which were full text, controlled clinical trial, study observational and articles published between 2019 and 2024 that addressed the prevention and treatment of post-spinal anesthesia headaches and exclusion articles that eliminated articles that were off topic, duplicates and those unavailable in full. Through the studies analyzed, it was observed that the use of smaller gauge needles (<25 G), neostigmine associated with atropine and a prophylactic dose of intrathecal morphine are preventive measures for PDPH. The treatments analyzed were epidural blood patch (EBP), nerve blocks and the use of atropine. Therefore, it is important to perform spinal anesthesia with smaller gauge needles in order to avoid the incidence of PDPH, and if this symptom exists, it is necessary to treat it with EBP, which is currently the most effective prevention and treatment.
- Ana Júlia Ornelas Piedade
- Letícia do Nascimento Freire
- Ramon Fraga de Souza Lima