title: [Incidence of accidental dura mater punctures in a university hospital: a prospective observational study].
abstract: OBJECTIVE
  Accidental dura mater puncture is a potential complication during epidural block, and may be associated with multiple factors. Our objective was to determine the prevalence and risk factors of accidental dural puncture in a university hospital, evaluating the differences in the number of complications during different working hours.
  
  
  METHODS
  A prospective observational study was conducted on all women who requested regional anaesthesia in the Epidural Analgesia Unit between 1 January 2009 and 1 January 2011, and who fulfilled the inclusion criteria. The technique employed to control labour pains was epidural analgesia.
  
  
  RESULTS
  A total of 12,480 pregnant women were included. The prevalence of accidental dura mater puncture was 0.4% (50 patients). Of these, 28% were due to medical residents. More accidental dura mater punctures were observed during September and in the afternoon shift.
  
  
  CONCLUSIONS
  The prevalence of accidental dura mater puncture is similar to other patient series. In ours, tiredness or lack of sleep did not influence the incidence of complications in analgesia for labour pains in a 24 hour care unit. This may be due to the distribution of on-call shifts not exceeding more than 6 hours.
authors.affiliation: Servicio de Anestesiología y Reanimación del Hospital de la Mujer, Sevilla, España. solebellas@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Bellas
authors.forename: M L
authors.initials: ML
authors.lastname: Marenco
authors.forename: A
authors.initials: A
authors.lastname: Sepúlveda
authors.forename: C
authors.initials: C
authors.lastname: Suan
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000776:Anesthesiology / Q000193:education; D003430:Cross-Sectional Studies; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007396:Internship and Residency; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014940:Work Schedule Tolerance; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000209:etiology