- 期刊
Gabapentin Relieves Post-dural Puncture Headache-A Report of Two Cases
抗癲癇藥物Gabapentin緩解硬脊膜穿刺後引起頭痛之病例報告
摘要
硬脊膜穿刺後引起的頭痛是脊椎麻醉或硬脊膜外腔麻醉後的一個合併症。治療原則採階梯式療法。從簡單的非侵入性的療法，如臥床、體液補充，或藥物治療，到侵入性的治療，如硬脊膜外腔血液貼補術。最近抗癲癇藥物gabapentin被用來預防或治療偏頭痛或其他頭痛。我們報告兩個硬脊膜穿刺後引起之頭痛以gabapentin治療成功的病例。硬脊膜穿刺後引起頭痛的病態生理學、gabapentin的藥理作用以及gabapentin緩解硬脊膜穿刺後引起頭痛的可能作用機轉都在文章中依次討論。
並列摘要
Post-dural puncture headache (PDPH) is a vexing problem of the patients following spinal anesthesia or a complication relative to inadvertent dural puncture in epidural anesthesia. The prevention and management of PDPH contain a laddered forestallment and therapy with varying results. The anticonvulsant gabapentin has been reported to be effective in prophylaxis and treatment of headaches. We report here two cases of PDPH, who failed to respond to traditional analgesics, but had good response to gabapentin. After treatment with gabapentin 400 mg three times daily, the headache was relieved remarkably in 24 hr. Discussions of the pathophysiology of PDPH, pharmacological actions of gabapentin, and possible mechanisms of action of gabapentin on PDPH are brought forward in the text.
延伸閱讀
- Cherng, C. H., Wong, C. S., & Ho, S. T. (2002). 硬脊膜外注射Ropivacaine後立刻引起抽筋之病例報告. Acta Anaesthesiologica Sinica, 40(1), 43-45. https://doi.org/10.6955/AAS.200203.0043
- Lin, S. Y., Wu, C. T., Yeh, C. C., Liu, S. T., Ho, S. T., & Wong, C. S. (1999). 抗癲癇藥物phenytion灌流時，使用麻黃素誘發完全房室傳導阻滯合併心室停止收縮－病例報告. Acta Anaesthesiologica Sinica, 37(1), 45-48. https://doi.org/10.6955/AAS.199903.0045
- Wu, Y. W., Hui, Y. L., & Tan, P. P. C. (1994). 用硬脊膜外血片治療腰椎穿剌後頭痛. Acta Anaesthesiologica Sinica, 32(2), 137-140. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199406-201904190012-201904190012-137-140
- 李君右（2016）。顱內硬腦膜動靜脈廔管併發重積性癲癇之個案經驗分享。腦中風會訊，23(1)，3-5。https://doi.org/10.6318/STROKE2016.23.1.2
- Wang, C. H., Yang, C. L., Lao, H. C., Cheng, J. K., Chen, C. C., & Lin, C. S. (2011). 以尾椎硬膜外腔血液注入凝固貼覆法治療薦椎神經周圍囊腫所引發之自發性顱內低壓－病例報告. 疼痛醫學雜誌, 21(1), 26-31. https://doi.org/10.29792/TTJP.201103.0005