TY - JOUR
T1 - Postdural puncture headache
T2 - A headache for the patient and a headache for the anesthesiologist
AU - Gaiser, Robert R.
PY - 2013/6
Y1 - 2013/6
N2 - PURPOSE OF REVIEW: To identify newly identified risk factors for the development of a postdural puncture headache (PDPH) as well as to outline the key points in the management of unintentional dural puncture and of PDPH. RECENT FINDINGS: The lack of experience of the proceduralist and a vaginal delivery are two risk factors that increase the risk of the patient developing a PDPH. The use of intrathecal catheters for the prevention of a headache is not of value, although an intrathecal catheter may prove to be the best method for providing analgesia for the patient. When performing an epidural blood patch, the optimal amount of blood is 20 ml, as long as the patient does not develop the symptoms of back pain or leg pain during the injection. SUMMARY: Many practitioners do not practice an evidence-based approach to the management of unintentional dural puncture and PDPH. Written institutional protocols are important to insure that patients receive the optimal care.
AB - PURPOSE OF REVIEW: To identify newly identified risk factors for the development of a postdural puncture headache (PDPH) as well as to outline the key points in the management of unintentional dural puncture and of PDPH. RECENT FINDINGS: The lack of experience of the proceduralist and a vaginal delivery are two risk factors that increase the risk of the patient developing a PDPH. The use of intrathecal catheters for the prevention of a headache is not of value, although an intrathecal catheter may prove to be the best method for providing analgesia for the patient. When performing an epidural blood patch, the optimal amount of blood is 20 ml, as long as the patient does not develop the symptoms of back pain or leg pain during the injection. SUMMARY: Many practitioners do not practice an evidence-based approach to the management of unintentional dural puncture and PDPH. Written institutional protocols are important to insure that patients receive the optimal care.
KW - Epidural blood patch
KW - Intrathecal catheter
KW - Postdural puncture headache
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U2 - 10.1097/ACO.0b013e328360b015
DO - 10.1097/ACO.0b013e328360b015
M3 - Review article
C2 - 23587730
AN - SCOPUS:84877733863
SN - 0952-7907
VL - 26
SP - 296
EP - 303
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
IS - 3
ER -