title: Evaluation of affecting factors and the effectiveness of treatment in cases with post-dural puncture headache who underwent epidural blood patch.
abstract: OBJECTIVE
  We evaluated post dural puncture headache (PDPH) cases and the contributing factors and monitored the treatment response with epidural blood patch (EBP), and other therapies.
  
  
  METHODS
  In this retrospective study, 77 PDPH cases treated with EBP were included. Patients were evaluated in terms of age, gender, type of surgery, type and diameter of the needle used for dural puncture, number(s) of dural puncture, onset of punctural headache, any conservative therapies for PDPH, number(s) of EBP application, analgesia quality at the 10th minute and 2nd hour after EBP application, and radicular pain during procedure.
  
  
  RESULTS
  The mean age of 77 patients (46 female, 31 male) was 31.5 ± 11.3, and the most common surgery performed was cesarean section. More than one attempt was applied in 48 patients. In 37 cases, a 22G spinal needle was used, while a 25 G spinal needle was used in 20 cases. The mean duration of the headache was 3.1 ± 1.3 days for female patients and 4.6 ± 2.3 days for male patients (p=0.020). VAS significantly decreased and patient satisfaction significantly increased after the 10th minute in patients who had EBP (p=0.001). In only one case (2%), the second EBP was needed for pain relief. Transient radicular pain was observed in 17 cases (22.07%) at administration of EBP.
  
  
  CONCLUSIONS
  In PDPH cases, EBP is an effective and relatively safe method, especially in obstetric patients. We reported that the PDPH symptoms presented earlier in female patients. A preference of a small diameter needle (less than 22 G) and avoidance of multiple attempts is important for spinal anesthesia.
authors.affiliation: Department of Anesthesiology and Reanimation, Division of Algology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey. lutfiyep@hotmail.com.
authors.forename: Lütfiye
authors.initials: L
authors.lastname: Pirbudak
authors.affiliation: Department of Obstetrics and Gynecology, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey.
authors.forename: Mete Gürol
authors.initials: MG
authors.lastname: Uğur
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziantep Childrens' Hospital, Gaziantep, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Kaya Uğur
authors.affiliation: Department of Biostatistics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
authors.forename: Seval
authors.initials: S
authors.lastname: Kul
authors.affiliation: Department of Anesthesiology and Reanimation, Division of Algology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Ganidağlı
mesh_terms: D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D017217:Blood Patch, Epidural; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D051299:Post-Dural Puncture Headache / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult