Chronic consequences of accidental dural puncture and postdural puncture headache in obstetric anaesthesia - sieving through the evidence.

Accidental dural puncture (ADP) and postdural puncture headache (PDPH) are relatively common complications of neuraxial anaesthesia and analgesia in obstetrics. Both may result in acute and chronic morbidity. This review intends to discuss the chronic implications of ADP and PDPH and raise awareness of severe and potentially life-threatening conditions associated with them. ADP may be associated with a high rate of PDPH, prolonged hospitalization and increased readmissions. Studies have shown that PDPH may lead to chronic complications such as post-partum depression (PPD), post-traumatic stress disorder (PTSD), chronic headache, backache and reduced breastfeeding rates. There are many case reports indicating that major, severe, life-threatening neurologic complications may follow PDPH in obstetric patients including subdural haematoma and cerebral venous thrombosis. Many clinicians still believe that ADP and PDPH are benign and self-limiting conditions whereas there may be serious and devastating consequences of both. It is imperative that all women with ADP and PDPH are appropriately diagnosed and treated.

Armstrong S ，Fernando R 《-》

Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric anaesthesia department.

Van de Velde M ，Schepers R ，Berends N ，Vandermeersch E ，De Buck F ... -  《-》

Postdural Puncture Headache and Epidural Blood Patch in a Large Obstetric Anaesthesia Population.

Martínez B ，Canser E ，Alonso A ，Alonso E ，Gredilla E ，Díez J ，Gilsanz F ... -  《-》

Post-dural puncture headache diagnosis and management.

Epidural analgesia, commonly used to alleviate labor pain, is not without complication. The most common complication associated with labor epidural analgesia (LEA) is Unintentional Dural Puncture (UDP), where many professionals go on to develop a Post Dural Puncture Headache (PDPH). Spinal anesthesia can also result in PDPH. Other complications of dural puncture necessitating further treatment include hospital readmission, persistent headache, persistent backache, cerebral venous thrombosis, subdural hematoma, postpartum depression, post-traumatic stress disorder, and decreased maternal breastfeeding. In this article, we will define and discuss the definition and diagnosis for PDPH, the pathophysiology of PDPH, PDPH treatment options including conservative therapy, pharmacologic therapy, and invasive procedural measures including the therapeutic epidural blood patch, prophylactic epidural blood patch, intrathecal catheter placement after UDP, and potential new therapies.

Vallejo MC ，Zakowski MI 《-》

The Relationship of Body Mass Index with the Incidence of Postdural Puncture Headache in Parturients.

Peralta F ，Higgins N ，Lange E ，Wong CA ，McCarthy RJ ... -  《-》