Postdural puncture headache: A headache for the patient and a headache for the anesthesiologist

Robert R. Gaiser

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)296-303
Number of pages8
JournalCurrent Opinion in Anaesthesiology
Volume26
Issue number3
DOIs
StatePublished - Jun 2013

Keywords

  • Epidural blood patch
  • Intrathecal catheter
  • Postdural puncture headache

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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