Intravertebrate anaesthesia is widely used in gynaecology operations, however, post-aesthetic headaches (PDPH) is one of the common complications. Such headaches can cause discomfort to gynaecologists and affect post-operative recovery. Therefore, knowledge of PDPH prevention and care measures is important for improving the comfort and quality of rehabilitation of gynaecologists.
I. Causes of post-aesthetic headaches in vertebrates
(1) Leaching of the spine
Anaesthesia needles in the vertebrae may cause a perforation of the hard-vertebrae and lead to a leak in the brain vertebrae due to, inter alia, thicker or inappropriate perforation techniques. When the loss of brain vertebrate fluid exceeds the amount generated, the brain vertebrate fluid pressure is reduced, the brain tissue is sunk, and the condensed hard membranes, blood vessels and nerves are drawn to cause headaches. Among gynaecologists, especially in cervix, there is a greater risk of headaches due to the frequent post-operative changes in the position of the patient to care for the newborn, which increases the degree of changes in the fluid pressure of the brain.
(2) Individual differences
1. Gender and age factors
Female patients are relatively more likely to have a PDPH, which may be related to female physiological characteristics. There is also a high incidence of young female patients, which may be related to their high dural elasticity and lack of closure after puncture. Young women are more likely to be involved in gynaecology operations, and this factor requires special attention.
2. Patient ‘ s own health status
A number of gynaecologists with conjunctive tissue diseases, low-circle stress syndrome, etc. are themselves subject to intracircle stress abnormalities and are more likely to suffer from headaches after anesthesia in the vertebrae.
II. Preventive measures
(1) Improved piercing techniques
1. Selection of suitable piercing needles
Intravertebranch punctures are used to the extent possible, and the degree to which the needles cause dribble damage is relatively small, reducing the incidence of brain vertebrate fluid leakage. For example, the use of 25G or 27G pen-tiping needles can significantly reduce the incidence of PDPH compared to traditional needles.
2. Enhancement of piercing skills
Anaesthetists should be highly trained and equipped with skilled and accurate piercing techniques. During the piercing process, the correct angle and direction of the needle is maintained, the number of repeated punctures is reduced and the risk of perforation is reduced.
(2) Patient position management
1. Post-aesthetic position
After anaesthesia of the vertebrae, the patient was directed to remain in a pillow for 6-8 hours. In the case of gynaecologists, especially after an hysterectomy, medical staff should explain in detail to the mother and family the importance of maintaining the correct position, so as to avoid a premature rise or rise, and to reduce sudden changes in the stress on the brain ‘ s spine.
2. Post-operative activity guidance
After the patient is able to move, the activity should be increased over time. From a slow turn, to a sitting, to standing and walking by the bed, to avoid sudden and dramatic changes in position. In the case of gynaecologists, such as women who need frequent activity to care for their newborns, special attention is drawn to the lightness of their movements.
(3) Rehydration therapy
Appropriate additional rehydration after the operation to maintain sufficient blood capacity. Sufficient liquids contribute to the generation of brain vertebrate fluids and contribute to the stability of brain vertebrate fluid pressure. In the case of gynaecologists, a reasonable adjustment of the rehydration velocity and quantity, depending on the condition of the operation and the state of the body, is generally possible to increase the input of crystall and adhesive fluids within 24 hours of the operation.
III. CARE MEASURES
(1) Headache assessment and monitoring
1. Pain assessment
Using appropriate pain assessment tools, such as visual simulation scoring (VAS), patients are regularly assessed for the extent, nature, frequency of onset, etc. In the case of gynaecologists, special attention is paid to the evolution of their headaches in different situations, such as breastfeeding and activities.
2. Vital signs monitoring
Life signs such as blood pressure, heart rate, breathing, etc. of patients are closely observed, as headaches may accompany changes in blood pressure. At the same time, care is taken to detect changes in the patient ‘ s condition in a timely manner, with the attendant symptoms of nausea, vomiting and blurred vision.
(2) Psychological care
1. Emotional comfort
(c) Explain to the patient the causes, duration and mitigation of headaches to alleviate the anxiety and fear of the patient. The mental state of gynaecologists, especially in the post-natal period, is sensitive and requires more attention and support.
2. Encouragement and guidance
Patients are encouraged to cooperate actively with treatment and care and to guide them in taking comfortable positions, such as half-beds, during headaches, to alleviate headaches. At the same time, informing patients of headaches is usually gradual over a period of days, increasing their confidence in recovery.
(3) Patient care
1. Pain relief
For mild headaches, they can be mitigated by rest, relaxation, etc. For persons with moderate severe headaches, appropriate painkillers may be granted on medical advice. At the same time, physical methods such as cold or heat dressing can be used to alleviate headaches, but care is taken that the temperature is appropriate to avoid freezing or burning patients.
2. Dealing with complications
If the patient has symptoms of nausea, vomiting, etc., he/she should be cleaned up in a timely manner to prevent misinhalation and be given anti-pussic drugs. For persons suffering from sleep disorders due to headaches, appropriate sleep interventions, such as the creation of a quiet and comfortable sleep environment, are available.
The prevention and care of vertebral anesthesia among gynaecologists is a comprehensive process. Through rigorous control and careful care of piercing techniques, patient position, rehydration treatment, etc., the incidence of PDPH can be effectively reduced and the suffering of patients reduced, and the successful rehabilitation of gynaecologists can be promoted.
