Postdural Puncture Headache and Epidural Blood Patch in a Large Obstetric Anaesthesia Population

Abstract

Background: Postdural puncture headache (PDPH) is the most common serious complication in obstetric anesthesia. We show the incidence of accidental dural puncture (ADP), PDPH, epidural blood patch (EBP) and the associated morbidity following an Obstetric Anesthesia Department´s protocol. Methods: An observational, prospective, analytical study was performed in 66.540 labor epidural analgesia. The objective is to describe the incidence of accidental dural puncture, postdural puncture headache and epidural blood patch in a large obstetric anesthesia practice population, as well as the associated morbidity of ADP and EBP. Results: The incidence of accidental dural puncture obtained was 0.76%, of postdural puncture headache 59%, and the global incidence of epidural blood patch 0.2%. Experience of the anesthetist performing the epidural (1st or 2nd year resident) and night time were associated with ADP. Low back pain rate was more frequent in those patients who received an epidural blood patch. Conclusion: We found an incidence of ADP and PDPH of 0.76% and 59% respectively. Experience of the anesthetist performing the epidural (1st or 2nd year resident) and nighttime were associated with ADP. EBP is a safe, easy and acceptable option as treatment for PDPH even with a higher risk of low back pain.