High-flow oxygen and pro-serotonin agents for non-interventional treatment of post-dural-puncture headache.
Am J Emerg Med
; 38(12): 2625-2628, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-33041133
ABSTRACT
OBJECTIVE:
Post dural puncture headache (PDPH) is a common complication in patients following diagnostic or therapeutic lumbar puncture, procedures requiring epidural access, and spinal surgery. Epidural blood patch (EBP), the gold standard for the treatment of this pathology requires training not provided to emergency physicians. In addition, the presence of concomitant pathology and abnormal laboratory values are contraindications to perform EBP. In presence of these limitations, we sought for a non-interventional management of PDPH utilizing high-flow oxygen and pro-serotonin agents. We reviewed the mechanism of action of this therapyMETHODS:
To illustrate our proposal, we report a series of twelve consecutive patients with PDPH treated with high-flow oxygen therapy at 12 L/min via a non-rebreathing mask and intravenous metoclopramide.RESULTS:
All patients were treated with this conservative therapy, no adverse reactions were observed. After the intervention, the headache resolved without further indications for PDPH.CONCLUSION:
Our series suggests that combining high-flow oxygen and pro-serotonin agents such metoclopramide in the ED might be a feasible option as effective as the invasive methods used in treating PDPH. This therapy appears to be efficient and to minimize risk, cost and side effects. It presents an easily accessible alternative that should be considered when PDPH is not a viable option.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Terapia por Inhalación de Oxígeno
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Cefalea Pospunción de la Duramadre
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Agonistas del Receptor de Serotonina 5-HT4
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Antagonistas del Receptor de Serotonina 5-HT3
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Metoclopramida
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Emerg Med
Año:
2020
Tipo del documento:
Article