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Postdural Puncture Headache and Epidural Blood Patch in a Large Obstetric Anaesthesia Population

Blanca Martínez1, Enrique Canser1, Alberto Alonso2

  • 1Anaesthesia Department, Hospital La Paz, Madrid, Spain.

Asian Journal of Anesthesiology
|June 1, 2018
PubMed

Insights

Postdural puncture headache (PDPH) is a common obstetric anesthesia complication. This study found an accidental dural puncture incidence of 0.76% and PDPH in 59% of cases, with epidural blood patch being a safe treatment.

Area of Science:

  • Anesthesiology
  • Obstetrics
  • Neurology

Background:

  • Postdural puncture headache (PDPH) is a significant complication in obstetric anesthesia.
  • Accidental dural puncture (ADP) can lead to PDPH, impacting patient recovery.

Purpose of the Study:

  • To determine the incidence of ADP, PDPH, and epidural blood patch (EBP) in a large obstetric anesthesia population.
  • To analyze the morbidity associated with ADP and EBP procedures.

Main Methods:

  • Observational, prospective, analytical study.
  • Involved 66,540 epidural labor analgesia procedures.
  • Monitored incidence of ADP, PDPH, EBP, and associated complications.

Main Results:

  • The incidence of ADP was 0.76%, and PDPH occurred in 59% of these cases.
  • Epidural blood patch (EBP) incidence was 0.2%.
  • Anesthetist experience (1st/2nd year resident) and night shifts correlated with ADP. Low back pain was more frequent post-EBP.

Conclusions:

  • ADP and PDPH have a notable incidence in obstetric anesthesia.
  • Anesthetist inexperience and night shifts are risk factors for ADP.
  • EBP is a safe and effective treatment for PDPH, though it carries a risk of low back pain.
Abstract

Keywords:
epidural blood patchobstetric accidental dural puncturepostdural puncture headacheprotocolrisk factors

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