Accidental dural puncture and post dural puncture headache in obstetric anaesthesia: presentation and management: a 23-year survey in a district general hospital.
Post dural puncture headache can be a debilitating complication of epidural and subarachnoid anaesthesia for a new mother. In a survey of 18,337 epidurals and 5021 subarachnoid blocks performed for obstetric procedures over a 23-year period in a district general hospital maternity unit, there were 167 recognised accidental dural punctures after epidurals (0.91%), with 147 patients (88%) developing post dural puncture headache. In addition there were 52 post dural puncture headaches after subarachnoid blocks (1.04%). Successful management of accidental dural puncture and post dural puncture headache requires adherence to clear policies and protocols, with close follow-up of patients by an experienced obstetric anaesthetist.
Sprigge
J S
JS
Arrowe Park Hospital, Upton, Wirral, CH49 5PE, UK. jsprigge@yahoo.co.uk
Harper
S J
SJ
D000700:Analgesics / Q000627:therapeutic use; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D017217:Blood Patch, Epidural; D004388:Dura Mater / Q000293:injuries; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D051299:Post-Dural Puncture Headache / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy
D000700:Analgesics