RT Journal Article
SR Electronic
T1 Subarachnoid Catheter Placement After Wet Tap for Analgesia in Labor: Influence on the Risk of Headache in Obstetric Patients
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 512
OP 515
DO 10.1016/S1098-7339(03)00393-6
VO 28
IS 6
A1 Sabry Ayad
A1 Yousef Demian
A1 Samer N Narouze
A1 John E Tetzlaff
YR 2003
UL http://rapm.bmj.com/content/28/6/512.abstract
AB Background and Objectives The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the incidence of PDPH.Methods Over a 5-year interval, 115 consecutive patients who had unintentional dural puncture were divided into 3 groups by consecutive assignment. Group A had an epidural catheter placed at another interspace. Group B had a subarachnoid catheter placed for labor analgesia that was removed immediately after delivery. Group C had a subarachnoid catheter that was left in place for 24 hours after delivery. Data were collected retrospectively. The incidence of PDPH and blood patch was compared between groups.Results The overall incidence of PDPH was 46.9% and need for blood patch 36.5%, significantly less in both subarachnoid catheter groups, 31% in B and 3% in group C, compared with group A (PDPH 81%) (P < .001).Conclusion Subarachnoid catheter placement after wet tap in obstetric patients reduces the PDPH rate and does so to a greater extent if left in place for 24 hours after delivery.