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Prolonged placement of spinal catheters does not prevent postdural puncture headache
N Liu1, A Montefiore, N Kermarec
1Département d'Anesthésie Réanimation, Hôpital Henri Mondor, Creteil, France.
Regional Anesthesia
|March 1, 1993
Summary
Leaving an intrathecal catheter in place after spinal anesthesia does not prevent postdural puncture headache (PDPH). The incidence of PDPH was similar whether the catheter was removed immediately or left for 12-24 hours.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Postdural puncture headache (PDPH) is a common complication following spinal anesthesia.
- Intrathecal catheter placement is sometimes used during spinal anesthesia procedures.
Purpose of the Study:
- To investigate if leaving an intrathecal catheter in place postoperatively reduces the incidence of PDPH.
- To compare PDPH rates between immediate catheter removal and delayed removal.
Main Methods:
- A randomized controlled trial involving 87 patients undergoing orthopedic surgery with spinal anesthesia.
- Patients received 0.5% bupivacaine via an 18-gauge Tuohy needle and a 20-gauge catheter.
- Postoperatively, patients were randomized to immediate catheter withdrawal (Group 1) or catheter retention for 12-24 hours (Group 2).
- PDPH was assessed by a blinded observer on postoperative days 1, 2, 3, and 8.
Main Results:
- The overall incidence of PDPH was 9.2%.
- There was no statistically significant difference in PDPH incidence between the immediate removal group (5/47 patients) and the delayed removal group (3/40 patients).
Conclusions:
- Leaving an intrathecal catheter in place for 12-24 hours postoperatively does not prevent postdural puncture headache.
- Current findings suggest that catheter dwell time does not influence PDPH occurrence.