Background and Aims Post dural puncture headache (PDPH) is a rare complication of neuroaxial analgesia/anesthesia, estimated to be less than 3%. However, it can impair neonatal care in the post-partum period. The aim of this audit was to evaluate the incidence of PDPH in our obstetric resident department and the need for different treatment options.
Methods Records’ review including all obstetric patients submitted to neuroaxial techniques between 2020 and 2021 in our obstetric department.
Results In a total of 5574 neuroaxial techniques performed in pregnant women, 33 were signaled for PDPH (0.59%). Of these, 17 were after an epidural technique, 11 following a sequential technique and 5 after a subarachnoid puncture. Out of 36 accidental dural punctures (ADP), only 15 presented symptoms of PDPH. Of the total 33 PDPH cases, 29 were initially treated with conservative measures, of which 8 had to escalate to sphenopalatine ganglion block (4 cases), great occipital nerve block (1 case) or epidural blood patch (EBP) (3 cases); The other 4 cases were initially treated with conservative treatment + sphenopalatine ganglion block (3 cases, of which 2 needed EBP) and 1 with conservative treatment + great occipital nerve block.
Conclusions Despite being a resident-teaching hospital, there is a relatively low incidence of PDPH, even after ADP – this could be due to preemptive conservative treatment instituted to avoid symptoms of PDPH. Even though PDPH is a rare complication of neuraxial technique, it is necessary to recognise its impairment in neonatal care and institute regular audits and adequate referencing and treatment protocols.