Background and Aims Postdural puncture headache (PDPH) is a major complication of neuraxial anesthesia which can occur following spinal anesthesia and with inadvertent dural puncture, during epidural anesthesia. Women’s, specially pregnancy women’s, are considered a group of risk for PDPH. Dural punctures during epidural placement occur with a frequency of 1.5% in the obstetric population, and around of 50% of those develop a PDPH. Hospitals should develop protocols for management of accidental dural puncture, including appropriate follow-up and indications for further management.

Methods We performed a survey of all patients treated for PDPH from January 2016 until December 2020. The patients analyzed in this study were examined by an anesthesia provider. Since december 2019, a new protocol has been developed for these situations. The forty-one womens inclued in this study started conservative measures such as: bed rest, oral hydration, analgesics and caffeine supplementation.

Results From 41 women identified, 59% reported relief of headache with the conservative treatment and 25% hadsymptomatic relief when thetreatment was associated with Sphenopalatine ganglion block (SGB). Since the implementation of this protocol, there is just a case needing an Epidural Blood Patch (EBP) due to failure of the SGB.

• Download figure
• Open in new tab
• Download powerpoint

Abstract B271 Figure 1

Conclusions Since PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. Our results show that, early identification of patients with PDPH and the initiation of conservative treatment favors a positive evolution. The association of the SGB to the conservative treatment proved to be favorable, leading to a decrease for more invasive treatments.