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HES Patch Versus Blood Patch

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University Hospital, Strasbourg, France

关键词

抽象

The injection of autologous blood Blood Patch (BP) into the epidural space is the standard treatment for headache associated with intracranial hypotension. It provokes cerebral vasoconstriction. It is cons-indicated in a number of situations (HIV positive, fever, sepsis, leukemia). The purpose of this study is to evaluate another technique using a patch made by injecting an epidural hydroxyethylstarch solution (HES 130, 0.4, 6%) instead of blood patch. This alternative technique is simple to implement and does not have some of the specific blood pressure contra-indications. The study aims at comparing the "Blood Patch" group versus the "HES Patch" in terms of clinical efficacy , tolerance, satisfaction of the anesthetist, ease of implementation and effect of the injection of epidural anesthesia on cerebral blood flow within 24 hours.

日期

最后验证: 07/31/2019
首次提交: 09/28/2015
提交的预估入学人数: 10/05/2015
首次发布: 10/06/2015
上次提交的更新: 08/18/2019
最近更新发布: 08/19/2019
实际学习开始日期: 05/31/2013
预计主要完成日期: 07/31/2018
预计完成日期: 07/31/2018

状况或疾病

Intracranial Hypotension

干预/治疗

Drug: Drug: injection of HES " Voluven® " patch arm

Biological: Blood Patch arm

-

手臂组

干预/治疗
Active Comparator: Blood Patch arm
Standard of care arm: injection of autologous blood approximately 40 mL of blood sample into the epidural space at a rate of 1 ml / about 5 seconds.
Biological: Blood Patch arm
Active Comparator: Drug: injection of HES " Voluven® " patch arm
Drug: injection of HES " Voluven® " into the epidural space of 15 to 30 ml at a rate of 1 ml / about 5 seconds
Drug: Drug: injection of HES " Voluven® " patch arm
Injection into the epidural space of 15 to 30 ml Voluven ® at a rate of 1 ml / about 5 seconds.

资格标准

有资格学习的年龄 18 Years 至 18 Years
有资格学习的性别All
接受健康志愿者
标准

Inclusion Criteria:

- Subjects older than 18 years.·

- Subjects with an intracranial hypertension syndrome secondary to an epidural, spinal or lumbar puncture (and therefore presumed iatrogenic) with a sub arachnoid space or subjects with intracranial hypertension syndrome of primitive origin requiring treatment with epidural Patch ·

- subjects with a temporal window of sufficient quality to carry out the transcranial Doppler ·

- Subjects haven read the informed consent, signed and dated prior to the start of any proceedings related to the tial·

- Subjects affiliated to health insurance·

- Subjects having been informed of the results of a prior medical consultation

Exclusion Criteria:

- Subjects with a cons-indication to an epidural Patch:

- blood disorders constitutional or acquired coagulation with platelets

- Subjects under treatment with curative doses of antiplatelet drugs or anticoagulants

- subjects under shock and / or hypovolemia

- subjects under generalized sepsis or at the puncture site

- any other cons-indication to performing an epidural

结果

主要结果指标

1. Variation of the pulsatility index (PI) of the middle cerebral artery transcranial Doppler [36 hours]

Compare the effect of epidural injection of autologous blood (Blood Patch) versus injection of a colloid (HES Voluven ®) on cerebral blood flow. this study aims at observing the variation of the pulsatility index (PI) of middle cerebral artery observed by a transcranial Doppler between T0 and 30 minutes after the patch is administered. The BP or HEA treatment will be considered equivalent if the proportion of clinical failures and side effects do not differ by more than 5%.

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