The management of dural puncture in obstetrics and the efficacy of epidural blood patches.
Epidural blood patch is the definitive treatment for post dural puncture headaches (PDH), providing acceptable short-term relief. Disappointingly however debate exists as to their long-term success. To investigate their efficacy in our practice, a retrospective audit of all epidural blood patches performed over a four year period was performed. Patients were subsequently followed up using a postal questionnaire and persistent symptom relief and patient satisfaction was measured. During the study period 87 patients required an epidural blood patch, 11 required repeat patches. 71.26% of patients had complete symptom resolution on discharge. The response rate to follow up survey was 73.26% with the majority, 57.44%, replying that their symptoms returned following their discharge home. Only 25.53% said they would have an epidural or spinal anaesthetic for future deliveries. Epidural blood patches provide excellent short-term relief but long-term results are disappointing. Patients receiving epidural blood patches need improved long-term follow up.
Eustace
N
N
Dept of Anaesthesia, Rotunda Hospital, Dublin 1, Ireland.
Hennessy
A
A
Gardiner
J
J
D000328:Adult; D000767:Anesthesia, Epidural; D017217:Blood Patch, Epidural; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D009774:Obstetrics; D005791:Patient Care; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome