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Post-dural puncture headache diagnosis and management.
Manuel C Vallejo1, Mark I Zakowski2
1Department of Medical Education, West Virginia University, Morgantown, WV, 26506, USA; Department of Anesthesiology, West Virginia University, Morgantown, WV, 26506, USA; Department of Obstetrics & Gynecology, West Virginia University, Morgantown, WV, 26506, USA.
Best Practice & Research. Clinical Anaesthesiology
|June 6, 2022
Summary
Post-dural puncture headache (PDPH) is a common complication of labor epidural analgesia (LEA) and spinal anesthesia. This review discusses PDPH causes, diagnosis, and various treatment options, including the epidural blood patch.
Area of Science:
- Anesthesiology
- Obstetrics
- Neurology
Background:
- Labor epidural analgesia (LEA) is a common pain management technique during childbirth.
- Unintentional dural puncture (UDP) during LEA or spinal anesthesia can lead to significant complications.
- Post-dural puncture headache (PDPH) is the most frequent complication, impacting maternal recovery.
Purpose of the Study:
- To define and discuss Post-dural puncture headache (PDPH).
- To explore the pathophysiology of PDPH.
- To review current and potential treatment strategies for PDPH.
Main Methods:
- Literature review of studies on epidural analgesia and PDPH.
- Analysis of diagnostic criteria and pathophysiological mechanisms.
- Evaluation of conservative, pharmacologic, and invasive treatment options.
Main Results:
- UDP is a frequent complication of LEA and spinal anesthesia, often resulting in PDPH.
- PDPH can lead to various other complications, including hospital readmission and neurological issues.
- Treatment options range from conservative measures to invasive procedures like the epidural blood patch.
Conclusions:
- PDPH is a significant concern following neuraxial procedures in laboring patients.
- Comprehensive understanding of PDPH pathophysiology is crucial for effective management.
- A range of therapeutic interventions exist, with the epidural blood patch being a primary invasive treatment.
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