title: A 5-year audit of accidental dural punctures, postdural puncture headaches, and failed regional anesthetics at a tertiary-care medical center.
abstract: Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65-0.82) for ADP, 0.49% (95% CI: 0.43-0.56) for PDPH, and 0.65% (95% CI: 0.57-0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p < 0.01), epidural block (p < 0.01), and vaginal delivery (p < 0.01).
authors: Magee-Womens Hospital, Department of Anesthesiology, University of Pittsburgh School of Medicine, USA.
authors: Sukhdip
authors: S
authors: Singh
authors: Shagufta Y
authors: SY
authors: Chaudry
authors: Amy L
authors: AL
authors: Phelps
authors: Manuel C
authors: MC
authors: Vallejo
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D006261:Headache / Q000209:etiology*; D006268:Health Facilities; D006801:Humans; D008485:Medical Audit; D011247:Pregnancy