HI
May I know what is the ideal gap between two spinals. Recently I had hot argument with one of the ortho surgeon who insisted for spinal for a patient who received spinal the other day. He asked me to show the articles for the same. Could you please quote any articles related.
can be given any number of time in the same day ,if patient accepts
Logically if lumber puncture can be done many times a day for diagnostic purpose, one can do LP for spinal also or repeat spinal also on the same day. As for the drug effect in spinal for repeatation, we all now know that we can put continuous spinal cath and give it as often as needed.
there is no clear data regarding duration between two spinal anesthesia,
but chance of getting spinal headache increases as complete closure of dural puncture site take 2-3 days and chances of csf leaking and consequently headache chances may increases.
patient can sue you for this if he develop headache
it can be given as many times,but i prefer gap of at least one day.
sir there is no contraindication for rept spinals. actually incidence of headache can increase as dural hole does not seal even after 2 week. i think you should just tell the surgeon you were wrong about the argument.
Quote from: kumar on February 26, 2007, 01:35:56 PM
can be given any number of time in the same day ,if patient accepts
Again PDPH remains ununderstandable, and unexplainable. Off late we see more of Meningism due to chemical irritation of meninges due to drugs we inject. I will quote an incidence. I was called to do a CSF manometry for a pt of Cavernous Synous Thrombosis. His pressure was about 1.25 meters. The physician used to request me to drain out some CSF to reduce his severe headache. I used to remove a lot of CSF. Almost every day he requested me to remove some CSF. I used to use a 20 G needle to drain it and deliberately I used to poke the needle in dura 5-6 times, hoping that he will have a leak there. But he used to get pain again in nest 2-3 hours. He used to bang his head on the wall as the headache was unbearable. In short, does a few more dura punctures really give a PDPH due to CSF leak? Specially as we now a days use needles which are 27G or Pencil point.