ABSTRACT
Thirty-six spontaneous intracranial hypotension patients with multiple-level leakages of cerebrospinal fluid were enrolled in the study.After 30 patients received targeted epidural blood intervention for 2 times and 6 patients received targeted epidural blood intervention for 3 times,the clinical symptoms were completely relieved.During injection of autologous blood,pain at the puncture site occurred in 24 cases,radiating pain in upper extremities in 5 cases,numbness in the upper extremity in 9 cases,radiating pain in lower extremities in 6 cases,numbness in lower extremities in 7 cases,headache in 4 cases,dizziness in 3 cases and transient bradycardia in 3 cases.Most of these symptoms were self-relieved after the end of injection or after slowing the injection rate,and some were self-relieved hours later.Neck stiffness was found in 2 cases and self-relived within a few hours or days after operation,and no severe nervous systemrelated complications were found.Recurrence happened in 2 cases at 3 months after the end of treatment,and the symptoms were self-relieved after receiving targeted epidural blood intervention for a second time.The patients were followed up for 15-36 months,and no serious nervous system-related complications were observed.Therefore,targeted epidural blood intervention is safe and effective when used to treat spontaneous intracranial hypotension caused by multiple-level leakages of cerebrospinal fluid in patients.
ABSTRACT
Objective To learn the present pain management quality at tertiary hospitals in China and the application of the quality evaluation system for acute pain management quality recommended by American Pain Society.Methods Analyzing the present pain management at five tertiary hospitals in China by using the evaluation system recommended by American Pain Society,questionnaires and medical records reading.Results The hospitals were found with setbacks in describing pains,recording pains with tools,using the right pain controls,using non-drug pain control measures and pain management outcomes; differences were found between the acute pain service group and non-acute pain service group in pain management quality,as the pain impacts of both groups on activities,emotion and sleep were 3.12±2.82 and 5.16±2.07 (P＜0.05) respectively.Conclusion Setbacks exist in both the process and outcomes of post-surgery pain management at these hospitals; those with acute pain service management are better than those without in terms of post-surgery pain management quality.The evaluation system recommended by American Pain Society is scientific,sensitive,practical and operable,extensively applicable to evaluation of acute pain management quality at hospitals in China.