• Can J Anaesth · Dec 2019

    A ten-year retrospective study of post-dural puncture headache in 32,655 obstetric patients.

    • Ana C Costa, James R Satalich, Ehab Al-Bizri, Shivam Shodhan, Jamie L Romeiser, Rishimani Adsumelli, Ramon E Abola, Ellen S Steinberg, and Elliott Bennett-Guerrero.
    • Department of Anesthesiology, Stony Brook Medical Center, Stony Brook, NY, USA. Ana.Costa@stonybrookmedicine.edu.
    • Can J Anaesth. 2019 Dec 1; 66 (12): 1464-1471.

    PurposeAccidental dural puncture and post-dural puncture headache are well-known complications of neuraxial anesthesia in parturients. The primary goal of this study was to identify the rate of post-dural puncture headache and epidural blood patch in all parturients who received a neuraxial anesthetic during a ten-year period at an academic tertiary-care medical centre. A secondary goal was to identify any delay in hospital discharge due to a post-dural puncture headache.MethodsWe conducted a retrospective analysis of all patients who received a neuraxial anesthetic on the labour and delivery unit at Stony Brook Medical Center from 1 January, 2006 to 31 December, 2015. Standardized neuraxial anesthesia equipment was used throughout this period. Chart reviews were conducted on all patients who received a neuraxial anesthetic and had an accidental dural puncture and/or developed a post-dural puncture headache.ResultsOf the 32,655 neuraxial anesthetics performed, 298 (0.9%) patients experienced a post- dural puncture headache. Analysis of all patients who developed a post-dural puncture headache showed that 150 (50.3%) patients received one or more epidural blood patches. Overall, 19 (0.06%) patients had a delay in hospital discharge due to a post-dural puncture headache.ConclusionsWe showed a relatively low incidence (< 1%) of post-dural puncture headache following neuraxial anesthesia in parturients at an academic tertiary-care medical centre. Patients that rated their post-dural puncture headache as very severe were more likely to undergo at least one epidural blood patch procedure. Post-dural puncture headache is a well-known complication of neuraxial anesthesia, and may lead to a delay in hospital discharge.

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