TY - JOUR
T1 - The management of accidental dural puncture and postdural puncture headache
T2 - A North American survey
AU - Baysinger, Curtis L.
AU - Pope, Jason E.
AU - Lockhart, Ellen M.
AU - Mercaldo, Nathaniel D.
N1 - Funding Information:
Supported by Vanderbilt University departmental funding only.
PY - 2011/8
Y1 - 2011/8
N2 - Study Objective: To evaluate the management of accidental dural puncture (ADP) and postdural puncture headache (PDPH) among obstetric anesthesiologists practicing in North America. Design: Questionnaire survey of individual members of the Society for Obstetric Anesthesia and Perinatology (SOAP). Setting: University hospital. Measurements: In June 2008, a 4-part, 83-item electronic survey was distributed to all North American members of SOAP. It contained questions about respondent demographics, epidural catheter and intrathecal catheter management after ADP, PDPH management, epidural blood patch (EBP) management, and patient follow-up. Main Results: Of the 843 United States and Canadian members of SOAP who were surveyed, 160 responses were collected. Respondents reported placing an epidural 75% of the time and an intrathecal catheter 25% of the time following ADP. Common prophylactic and conservative treatment strategies included hydration, caffeine, and opioids by mouth; 76% of respondents leave an intrathecal catheter in place for 24 hours to reduce the frequency of headache. Epidural blood patches are placed by 81% of practitioners less than 24 hours after headache onset. Conclusions: Protocols for ADP management are rare. There is wide variation in catheter management after dural puncture, measures used to prevent and treat a resultant headache, and EBP management.
AB - Study Objective: To evaluate the management of accidental dural puncture (ADP) and postdural puncture headache (PDPH) among obstetric anesthesiologists practicing in North America. Design: Questionnaire survey of individual members of the Society for Obstetric Anesthesia and Perinatology (SOAP). Setting: University hospital. Measurements: In June 2008, a 4-part, 83-item electronic survey was distributed to all North American members of SOAP. It contained questions about respondent demographics, epidural catheter and intrathecal catheter management after ADP, PDPH management, epidural blood patch (EBP) management, and patient follow-up. Main Results: Of the 843 United States and Canadian members of SOAP who were surveyed, 160 responses were collected. Respondents reported placing an epidural 75% of the time and an intrathecal catheter 25% of the time following ADP. Common prophylactic and conservative treatment strategies included hydration, caffeine, and opioids by mouth; 76% of respondents leave an intrathecal catheter in place for 24 hours to reduce the frequency of headache. Epidural blood patches are placed by 81% of practitioners less than 24 hours after headache onset. Conclusions: Protocols for ADP management are rare. There is wide variation in catheter management after dural puncture, measures used to prevent and treat a resultant headache, and EBP management.
KW - Accidental dural puncture
KW - Analgesia: epidural, intrathecal
KW - Anesthesia, neuraxial, obstetrical
KW - Epidural blood patch
KW - Intrathecal catheter
KW - Postdural puncture headache
UR - http://www.scopus.com/inward/record.url?scp=79960953808&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2011.04.003
DO - 10.1016/j.jclinane.2011.04.003
M3 - Article
C2 - 21696932
AN - SCOPUS:79960953808
SN - 0952-8180
VL - 23
SP - 349
EP - 360
JO - Journal of clinical anesthesia
JF - Journal of clinical anesthesia
IS - 5
ER -