• Ayda Turkoz, Aysu Kocum, H Evren Eker, Hacer Ulgen, Mustafa Uysalel, and Gulnaz Arslan.
• Department of Anesthesiology, Baskent University Adana Teaching and Medical Research Center, Adana, Turkey. aydaturkoz@yahoo.com
• J Anesth. 2010 Feb 1;24(1):43-8.

PurposeWe investigated whether inserting an intrathecal catheter and leaving it in place for 24 h after an unintentional dural puncture in orthopedic patients reduced the incidence of post-dural puncture headache (PDPH).MethodsThe study consisted of 427 patients in whom a total of 21 unintentional dural punctures had occurred during orthopedic surgery performed between 2002 and 2006. Seven patients (phase I; evaluated retrospectively) each underwent placement of an epidural catheter at another level after dural puncture during the period January 2002 to February 2004. Fourteen patients (phase II; evaluated prospectively) received an epidural catheter through the dural tear after an unintentional dural puncture during the period February 2004-March 2006ResultsIn phase I, 5 of the 7 patients experienced PDPH, and one required an epidural blood patch. In phase II, only one of the 14 patients complained of PDPH, which resolved after 48 h of medical therapy. No patient experienced paresthesia, neurologic or hemorrhagic complication, or infection.ConclusionInserting an epidural catheter through the dural tear following an unintentional dural puncture and leaving it in place for 24 h significantly reduces the incidence of PDPH.

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