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長時間之絕對平躺減少脊椎麻醉後頭痛之效果

Prolonged Bed Rest for Preventing Post-Dural Puncture Headache

摘要


脊椎麻醉後之頭痛是脊椎穿刺最常見之併發症之,目前台灣多數醫院針對脊髓麻醉手術後之病人,常規需絕對平躺8小時,以避免病人產生脊髓麻醉後頭痛之併發症。本文以實證醫學之觀點,經由五項步驟,探討「長時間之絕對平躺是否可減少脊椎麻醉後之頭痛」目前文獻之證據顯示,長時間之絕對平躺反而增加脊椎麻醉後頭痛之機會,因此病患術後若沒有其他不便下床活動之禁忌症,應准許病患下床活動。

並列摘要


Post-dural puncture headache (PDPH) is one of the most common complications in patients who finished spinal anesthethia procedure. Currently prolonged absolute bed rest for eight hours to prevent PDPH is generally performed in many hospitals in Taiwan. By applying "Evidence-based medicine", through five steps, we evaluate whether prolonged absolute bed rest can prevent PDPH. According to literature review, there is no evidence that prolonged bed rest is beneficial to prevent PDPH. Thus rest after spinal anesthesia to prevent PDPH should not be routinely recommended. Instead, people should be allowed to move freely in accordance with their ability and medical recommendations.

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