title: [Accidental dural puncture during epidural injection of corticosteroids: a different approach?].
abstract: We report 6 cases diagnosed with accidental dural puncture after epidural injection of corticosteroids for low back pain. All the patients reported postdural puncture headache during their stay in the postanesthetic recovery unit. For 3 patients, pain resolved with treatment given in the recovery unit. Two other patients also required mild analgesics for 1 week. In the last patient, a blood patch was used to treat incapacitating headache 22 days after the epidural procedure and mild analgesics were needed for 4 more weeks. It is important to establish a protocol for treating postdural puncture headache in pain clinics to facilitate decision making. Good physician-patient communication is necessary to avoid refusals for permission for other epidural techniques and to facilitate management of symptoms.
authors.affiliation: Sección de Anestesia, Hospital de Laredo, Laredo, Cantabria. mgalindopalazuelos@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Galindo Palazuelos
authors.forename: I
authors.initials: I
authors.lastname: González Fernández
authors.forename: A
authors.initials: A
authors.lastname: Fernández Abascal
authors.forename: N
authors.initials: N
authors.lastname: Díaz Setién
authors.forename: F J
authors.initials: FJ
authors.lastname: Manso Marín
authors.forename: A
authors.initials: A
authors.lastname: Castro Ugalde
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones