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Erschienen in: Die Anaesthesiologie 8/2022

14.07.2022 | Postdural Puncture Headache | CME

Postpunktionskopfschmerz in der Geburtshilfe

Pathogenese, Diagnostik und Therapie

verfasst von: Dr. med. Benedikt Hermann Siegler, Dr. med. Beatrice Oehler, Prof. Dr. med. Peter Kranke, Prof. Dr. med. Markus Alexander Weigand

Erschienen in: Die Anaesthesiologie | Ausgabe 8/2022

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Zusammenfassung

Der Postpunktionskopfschmerz („postdural puncture headache“, PDPH) zählt zu den wesentlichen Komplikationen der peripartalen neuroaxialen Analgesie. Als ursächlich gelten der Verlust von Liquorvolumen und -druck sowie die kompensatorisch auftretende intrakranielle Vasodilatation. Potenziell schwerwiegende Langzeitfolgen erfordern die korrekte PDPH-Diagnose, den Ausschluss relevanter Differenzialdiagnosen (ggf. mithilfe bildgebender Verfahren) und die rasche Einleitung einer effektiven Therapie. Nichtopioidanalgetika, Koffein sowie ggf. Theophyllin, Gabapentin und Hydrokortison bilden therapeutische Grundpfeiler; bei persistierenden Beschwerden ist die zeitnahe Anlage eines epiduralen Blut-Patch (EBP) der Goldstandard. Verfahren der Neuraltherapie stellen vielversprechende Alternativen dar, insbesondere wenn ein EBP nicht erwünscht oder kontraindiziert ist. Ein interdisziplinär und interprofessionell abgesprochenes Standardvorgehen kann zur Optimierung des klinischen Managements dieser relevanten Komplikation beitragen.
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Metadaten
Titel
Postpunktionskopfschmerz in der Geburtshilfe
Pathogenese, Diagnostik und Therapie
verfasst von
Dr. med. Benedikt Hermann Siegler
Dr. med. Beatrice Oehler
Prof. Dr. med. Peter Kranke
Prof. Dr. med. Markus Alexander Weigand
Publikationsdatum
14.07.2022
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 8/2022
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-022-01171-2