• Ann Fr Anesth Reanim · May 2014

    Case Reports

    Accidental dural puncture: Combination of prophylactic methods to avoid post-dural puncture headache.

    • J Gobin, L Lonjaret, A Pailhas, F Bayoumeu, and V Minville.
    • Département d'anesthésie et réanimation, CHU de Toulouse, université Paul Sabatier, hôpital Purpan, place du Dr-Baylac, 31059 Toulouse cedex 9, France. Electronic address: julie.gobin@gmail.com.
    • Ann Fr Anesth Reanim. 2014 May 1;33(5):e95-7.

    AbstractAccidental dural puncture (ADP) is a common complication of epidural catheter insertion, and may lead to post-dural puncture headache (PDPH), especially in obstetric patients. Epidural blood patch (BP) is the most effective treatment of PDPH. Prophylactic BP has shown its efficacy to prevent PDPH; nevertheless, this method may be insufficient. We report an ADP case before induction of labor in a 28-year-old parturient. To avoid PDPH, an intrathecal catheter was immediately inserted after ADP and an epidural catheter was also inserted at the interspace above. Catheters were kept in place for more than 24hours. A prophylactic BP was performed immediately after removal of the intrathecal catheter. The patient did not experience any headache. This combination of treatments (intrathecal catheter insertion+prophylactic BP) may be a good alternative approach to prevent PDPH, even if it has to be warranted by other clinical studies.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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