Post-dural headache in obstetrics: a complication of epidurals and spinals

Abstract

Post-dural puncture headache (PDPH) is a well-known complication of spinal or epidural anaesthesia and diagnostic lumbar puncture. It represents the most common potentially serious complication of obstetric regional analgesia and anaesthesia. The reported incidence of accidental dural puncture during epidural analgesia is around 1%, although with considerable variation between units. This contribution covers the aetiology of and contributory factors to PDPH, presentation and diagnosis, management – including drug treatment and epidural blood patch – and prevention.