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Related Experiment Videos

Postdural puncture headache: a literature review.

J H Hess

    AANA Journal
    |December 1, 1991
    PubMed
    Summary

    Postdural puncture headache (PDPH) is a common side effect of spinal anesthesia. This review covers its causes, prevention strategies like small needles, and treatments such as caffeine and epidural blood patching.

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    Area of Science:

    • Anesthesiology
    • Neurology

    Background:

    • Postdural puncture headache (PDPH) is the second most frequent complication following spinal anesthesia.
    • It is characterized by a headache that worsens when upright and improves when lying down.

    Purpose of the Study:

    • To review the literature on the causes, prevention, and treatment of PDPH.
    • To consolidate current understanding of PDPH management.

    Main Methods:

    • Literature review of studies published between 1943 and mid-1989.
    • Analysis of etiological factors, prophylactic measures, and therapeutic interventions for PDPH.

    Main Results:

    • PDPH is attributed to cerebrospinal fluid (CSF) leakage and subsequent cranial vascular distension.
    • Preventive measures include using small-gauge needles and potentially the lateral approach.
    • Effective treatments discussed include continuous epidural saline infusion, caffeine sodium benzoate (70-80% success), and epidural blood patching (90%+ success).

    Conclusions:

    • Understanding the pathophysiology of PDPH is crucial for effective management.
    • A combination of preventive techniques and evidence-based treatments can significantly reduce PDPH incidence and severity.
    • Epidural blood patching is presented as a highly successful treatment option.

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