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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)

Published on: January 27, 2010

Post partum headache after epidural analgesia without dural puncture

D Benhamou1, J Hamza, B Ducot

  • 1Le Département d'Anesthésie-Réanimation Chirurgicale, Hôpital Antoine Béclère, Université Paris-Sud, France.

International Journal of Obstetric Anesthesia
|January 1, 1995
PubMed

In order to improve our knowledge of post partum headache, during a two-year period we studied a large population of pregnant patients of our institution using a four-stage process including two questionnaires (the first at 12-15 weeks' gestation and the second in the first week after delivery), a pre-anesthetic visit at 36 +/- 2 weeks' gestation and a computer printout obtained at delivery. Of 1058 patients for whom records were complete and who had epidural analgesia during labor not complicated by dural puncture, 128 (12.1%) complained of post partum headache. In patients who did not receive epidural analgesia, the incidence of post partum headache tended to be higher (15.2%). However, because of the low response rate (27.1%) and the low absolute number of patients with headache (27) in the non-epidural group, statistical comparison was not possible. Data from the medical history or from the current pregnancy as well as data obtained during delivery (maternal and fetal-neonatal) were not significantly different between those patients free of pain and those presenting with headache, except for a history of migraine and pregnancy-induced hypertension which were both associated with an increased risk of post partum headache. These risk factors should be considered in both clinical studies and obstetric malpractice claims.

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