Article Text
Abstract
Background and Aims Post dural puncture headache is relatively common in obstetric patients who have received central neuraxial anaesthesia1. Symptoms of PDPH are often severe, debilitating and potentially long lasting2. Treatment options for PDPH are limited and the only treatment which has been shown to be effective is an epidural blood patch3. EBP carries risks in itself and the decision to perform this is not taken lightly. Performing an EBP requires appropriate assessment of the patient, consenting of the procedure and follow up among other recommendations.
Methods We anonymously retrospectively looked collected data regarding all epidural blood patches performed in a single centre over a 4 year period. Details of the dural puncture, onset of symptoms, consent, documentation of risks, procedure details and follow up were all recorded. We have compared this to the OAA recommendations.
Results 23 blood patches in 20 patients, 8 patients had only spinal, 2 had an epidural followed by spinal while 10 had only epidural procedure. Headache developed within 48h in 17 cases, Blood patch was performed between day 2 and day 6 in 18 patients. There is one patient that had blood patch day 10 and 13 with complete resolution of symptoms day 14 from initial epidural, and another patient that had blood patches day 3 and 23 post initial spinal. in the epidural group 8 were recognised as dural taps on insertion.
Conclusions We have practice according to OAA recommendation, they were adequately consented and they were given 48h of conservative treatment and they were followed up adequately.