• Maren Kleine-Brüggeney and Ulrike M Stamer.
• Klinik für Anästhesiologie und Schmerztherapie des Inselspitals, Universitätsklinikum Bern. maren.kleine-brueggeney@insel.ch
• Anasthesiol Intensivmed Notfallmed Schmerzther. 2011 Jul 1;46(7-8):516-24.

AbstractSince the first description of spinal and epidural anaesthesia, postdural puncture headache (PDPH) is a well known complication. Its prophylaxis and treatment has been studied and discussed for more than 100 years, but the evidence is still limited. Due to relatively low prevalence of PDPH, prospective RCTs are often missing, and the frequently self-limiting character of PDPH impedes an adequate interpretation of results from studies without a control group. Taking side effects and complications into account, a prophylactic treatment of PDPH cannot be recommended. In case of PDPH, non-opioid analgesics are the first choice treatment. The epidural blood patch remains the mainstay of severe PDPH therapy. Noninvasive therapies like theophylline, sumatriptan and ACTH can be an alternative. However, an evidence-based recommendation is lacking. The development of standard operating procedures for accidental dural punctures and PDPH is recommended.© Georg Thieme Verlag Stuttgart · New York.

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