scholarly journals RISK FACTORS, CLINICAL MANIFESTATION AND PREVENTION OF POST-DURAL PUNCTURE HEADACHE IN THE OBSTETRIC FIELD

2021 ◽  
Vol 31 (5) ◽  
pp. 73-76
Author(s):  
Matas Kalinauskas ◽  
Mantilė Juotkutė
Keyword(s):  
Risk Factors ◽  
Dural Puncture ◽  
Fluid Pressure ◽  
Intrathecal Catheter ◽  
Post Dural Puncture Headache ◽  
Blood Patch ◽  
Accidental Dural Puncture ◽  
History Of ◽  
Prospective Trials ◽  
Low Body Mass Index

Introduction: Over the past decades, the number of wo­men choosing to have epidural analgesia or undergoing spinal anesthesia during labor is steadily increasing. Con­sequently, a risk for complications is increasing. Post-dural puncture headache (PDPH) is considered one of the most common complication following accidental dural puncture (ADP). Sources and a method: A literature overview were con­ducted via search engine “PubMed (Medline)” and “Goo­gle Scholar”. Randomized controlled trials, meta – analy­sis, retrospective, prospective trials and systemic reviews on PDPH were selected. Aim of the review: To evaluate the most commonly des­cribed risk factors, clinical presentation and prevention of PDPH in the obstetric field. Results: The occurrence of ADP during neuraxial anest­hesia reported in the literature is relatively small – 0,1 – 1,5%. PDPH is a potentially expected complication after any lumbar punction. It presents as a headache within five days of the puncture due to low cerebrospinal fluid pressure. The pain is often bilateral, located in the frontal or occipital areas. Symptoms, such as vision and hearing impairment, neck pain and nausea might follow. Usually, the symptoms fade out spontaneously within two weeks. Risk factors for PDPH are modifiable (technique of the injection and anesthesiologist’s skills) and non-modifia­ble (pregnancy, low body mass index (BMI), dehydra­tion, history of PDPH). The goal of preventing PDPH is to identify and correct the risk factors associated with this condition. Main described means being equipment and experience, conservative measures, administration of epidural morphine, intravenous dexamethasone or co­syntropin, epidural blood patch and intrathecal catheter. Conclusions: 1. PDPH manifests as an orthostatic hea­dache with or without ocular, neural, hearing and other symptoms. 2. Young pregnant women with low BMI are more likely to suffer from PDPH. 3. PDPH preven­tion consists of risk factor correction and proper medi­cal techniques.

scholarly journals Punção Acidental da Dura e Cefaleia Pós-punção da Dura na População Obstétrica: Oito Anos de Experiência

2016 ◽  
Vol 29 (4) ◽  
pp. 268
Author(s):  
Maria Vaz Antunes ◽  
Adriano Moreira ◽  
Catarina Sampaio ◽  
Aida Faria
Keyword(s):  
Conservative Treatment ◽  
Epidural Catheter ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Spinal Block ◽  
Post Dural Puncture Headache ◽  
Retrospective Audit ◽  
Prophylactic Measures ◽  
Blood Patch ◽  
Accidental Dural Puncture

<p><strong>Introduction:</strong> Accidental dural puncture is an important complication of regional anesthesia and post-dural puncture headache remains a disable outcome in obstetric population. The aim of our study was to calculate the incidence of accidental puncture and post-puncture headache and evaluate its management among obstetric anesthesiologists.<br /><strong>Material and Methods:</strong> We conducted a retrospective audit, between January 2007 and December 2014. We reviewed the record sheets of patients who experienced either accidental puncture or post-puncture headache. We excluded the patients undergoing spinal block. We use the SPSS 22.0 for statistical analyses.<br /><strong>Results:</strong> We obtained 18497 neuro-axial blocks and 58 accidental dural punctures (0.3%). After detected puncture, in 71.4% epidural catheter was re-positioned and 21.4% had intra-thecal catheters. Forty-five (77.6%) developed headache and the prophylactic measures were established in 76.1%. Conservative treatment was performed in all patients. The epidural blood patch was performed in 32.8% with a 84.2% of success.<br /><strong>Discussion:</strong> The incidence of post-dural puncture headache is unrelated to the type of delivery or insertion of intrathecal catheter. The re-placement of the epidural catheter remains the main approach after puncture. The institution of prophylactic measures is a common practice, despite the low level of evidence. We performed epidural blood patch after failure of conservative treatment.<br /><strong>Conclusion:</strong> The incidence of accidental dural puncture and post-dural puncture headache was similar to the literature. Despite being a common complication, there remains lack of consensus on its approach.</p>

POST-DURAL PUNCTURE HEADACHE AND RISK FACTORS IN WOMEN UNDERGOING CESAREAN SECTION WITH SPINAL ANESTHESIA

2019 ◽  
pp. 37-43
Author(s):  
Thi Minh Thu Pham ◽  
Thi Hoang Yen Do ◽  
Van Long Le ◽  
Van Minh Nguyen ◽  
Viet Ha Vo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Local Anesthesia ◽  
Dural Puncture ◽  
Insertion Site ◽  
Moderate Pain ◽  
Needle Size ◽  
Post Dural Puncture Headache ◽  
History Of

Objective: To estimate the incidence of post-dural puncture headache (PDPH) and risk factors in women underwent Cesarean section with spinal anesthesia. Materials and method: In a prospective descriptive study, parturients underwent Cesarean section with spinal anesthesia. Incidence of post-dural puncture headache, the history of spinal anesthesia and PDPH, presence of headache, preeclampsia, migraine, sinusitis, caffeine withdraw, insertion site, repeated puncture attempts, direction of the needle, size of the needle, local anesthesic, perioperative hypotension, nausea and vomiting, amount of intravenous fluid were recorded. Results: There were 389 patients in the study. The incidence of PDPH was 14.65% (mild and moderate pain: 75.44%; severe pain 21.05%; worst pain: 3.51%). The risk factors were history of PDPH (OR = 4.5; 95% CI: 1.8 - 11.09), sinusitis (OR = 2.65; 95% CI: 1.10 - 6.36), local anesthesia (Marcain spinal 0.5% heavy) (OR = 6.66; 95% CI: 2.25 - 19.11), perioperative hypotension (OR = 2.42; 95% CI: 1.25 - 4.70). Conclusion: The incident of PDPH in women undergoing Cesarean section with spinal anesthesia was 14.65%. Four risk factors were the history of PDPH, sinusitis, local anesthesia (Marcain spinal 0.5% heavy) and perioperative hypotension. Key words: post-dural puncture headache (PDPH), Cesarean section, spinal anesthesia

scholarly journals Post-dural Puncture Headache in Cesarean Section; Frequency and Risk Factors: A Report From the North of Iran

2021 ◽  
Vol 7 (4) ◽  
pp. 202-208
Author(s):  
Ali Mohammadzadeh Jouryabi ◽  
◽  
Abbas Sedighinejad ◽  
Cyrus Emir Alavi ◽  
Gelareh Biazar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Dural Puncture ◽  
Demographic Data ◽  
Related Factors ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
The North ◽  
North Of Iran ◽  
History Of

Background: Spinal Anesthesia (SA) as a safe, reliable, and cost-effective method is widely used for Cesarean Section (CS). However, it is sometimes complicated by Post-Dural Puncture Headache (PDPH). Objectives: We investigated the frequency of PDPH in CS under SA and related risk factors in an academic referral hospital in the north of Iran. Materials & Methods: This descriptive cross-sectional prospective study was conducted at Alzahra hospital as an academic referral center affiliated with the Guilan University of Medical Sciences on 147 eligible cases During from May 2019 to October 2019. Then questionnaires containing questions about patients’ demographic data and some PDPH-related factors were filled out via face-to-face interviews. The collected data were analyzed by SPSS v. 21 using Chi-squared and and Fisher’s exact test. Results: The incidence of PDPH was 6.1%. Early ambulation, the number of attempts, and having a history of headache were significantly associated with a higher incidence of PDPH (P=0.001), while body mass index (P=0.106), age (P=0.093), and residents’ experience (P=0.384) had no significant association. None of our cases experienced a severe or persistent headache. Conclusion: The main predisposing factors for PDPH were found to be the history of HA, early ambulation, and the number of dura punctures. Women at risk for PDPH should be objectively screened before CS under SA.

scholarly journals Epidural blood patch in post-dural puncture headache in parturients: A case series

2020 ◽  
Vol 9 (3) ◽  
pp. 169-172
Author(s):  
Babu Raja Shrestha ◽  
Shyam Krishna Maharjan ◽  
Ujma Shrestha ◽  
Sushila Lama Moktan
Keyword(s):  
Pharmacological Treatment ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Autologous Blood ◽  
Case Series ◽  
Post Dural Puncture Headache ◽  
Blood Patch ◽  
Typical History ◽  
History Of ◽  
Persistent Headache

This is a case series of six obstetric patients who had post-dural puncture headache, resistant to conservative treatment. The onset of post-dural headache in our series on average was on the 34th hour of the procedure. After confirmation of the diagnosis with a typical history of presentation and examination, the patients underwent pharmacological treatment. Post-dural puncture headache, in our series, not relieved by pharmacological treatment underwent epidural blood patch after persistent headache in an average of 5 days post-dural puncture. All patients receiving this therapy had a complete cure of headache at the earliest - from 45 minutes to as late as 11 hours post procedure. Epidural autologous blood instillation in an average of 10 to 11 ml completely relieved the ailment in the primary blood patch. Epidural blood patch is still considered gold standard therapy in persistent post-dural puncture headache.

scholarly journals Epidural Blood Patch for Chronic Daily Headache with Postural Component: A Case Report and the Review of Published Cases

2008 ◽  
Vol 1;11 (1;1) ◽  
pp. 77-80
Author(s):  
Shihab Ahmed
Keyword(s):  
Chronic Daily Headache ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Acute Onset ◽  
Postural Headache ◽  
Post Dural Puncture Headache ◽  
Blood Patch ◽  
History Of ◽  
Daily Headache ◽  
One Year

Post dural puncture headache (PDPH) can be observed after any trauma to the dura. The hallmark of PDPH is an increasing headache when assuming the upright position and improvement with the supine position. Diagnosis of PDPH is essentially based on history of dural puncture and clinical presentation. In most cases, if initial conservative therapies fail to provide the relief of symptoms, an epidural blood patch is the therapy of choice. Epidural blood patch is a safe and effective treatment for PDPH and routinely done for acute onset of postural headache after spinal or epidural anesthesia or analgesia. Here, we report the successful treatment of chronic daily headache with a postural component via an epidural blood patch one year after the onset. We also review the literature pertinent to the use of epidural blood patch in chronic daily headache patients with postural component. Key words: Post-dural puncture headache, postural headache, chronic daily headache, epidural blood patch

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