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    Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34311


    標題: Efficacy of greater occipital nerve block for pain relief in patients with postdural puncture headache A meta-analysis
    作者: Chang, Ying-Jen
    Hung, Kuo-Chuan
    Chen, I-Wen
    Kuo, Chi-Lin
    Teng, I-Chia
    Lin, Ming-Chung
    Yew, Ming
    Liao, Shu-Wei
    Wu, Chung-Yi
    Yu, Chia-Hung
    Lan, Kuo-Mao
    Sun, Cheuk-Kwan
    貢獻者: Chi Mei Med Ctr, Dept Anesthesiol
    Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management
    E Da Hosp, Dept Emergency Med
    I Shou Univ, Coll Med, Sch Med Int Students
    關鍵字: epidural blood patch
    greater occipital nerve block
    neuraxial anesthesia
    postdural puncture headache
    日期: 2021
    上傳時間: 2023-11-11 11:42:41 (UTC+8)
    出版者: LIPPINCOTT WILLIAMS & WILKINS
    摘要: Background: This study aimed at assessing the therapeutic effectiveness of greater occipital nerve block (GONB) against postdural puncture headache (PDPH). Methods: Studies investigating analgesic effects of GONB against PDPH in adults were retrieved from the MEDLINE, EMBASE, Google scholar, and Cochrane central databases from their inception dates to May, 2021. Pain score at postprocedural 24 hours was the primary endpoint, while secondary endpoints were pain score at postprocedural 1 hour and 12 hours as well as the risk of intervention failure. Results: Of the 7 studies (randomized controlled trials [RCTs], n = 4; non-RCTs, n = 3) that recruited 275 patients, 2 investigated female patients undergoing cesarean section and the other 5 were conducted in both obstetric and nonobstetric settings. Pooled results showed a lower mean pain score at 24 hours (i.e., primary outcome) (mean difference [MD] = -2.66, 95%: CI: -3.98 to -1.33, P I-2 = 97%, 6 studies), 1 hour (MD = -4.23, 95% confidence interval [CI]: -5.08 to -3.37, P I-2 = 86%, 5 studies), and 6 hours (MD = -2.78, 95% CI: -4.99 to -0.57, P = .01; I-2 = 98%, 4 studies) in patients with GONB compared to those without. Trial sequential analysis supported the robustness of evidence at postprocedural 24 hours. The use of GONB also decreased the risk of intervention failure (relative ratio [RR] = 0.4, 95% CI: 0.19 to 0.82, P = .01; I-2 = 96%, 6 studies, 277 patients). Conclusion: Our results suggested a therapeutic effect of greater occipital nerve block against postdural puncture headache up to postprocedural 24 hours. Further large-scale studies are warranted to evaluate its therapeutic benefit beyond the acute stage.
    關聯: MEDICINE, v.100, n.51, e28438
    Appears in Collections:[休閒保健管理系(所)] 期刊論文

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