Post Dural Puncture Headache After Accidental Dural Puncture

Sunnybrook Health Sciences Centre

Status: Withdrawn

Conditions: Post Dural Puncture Headache

Study type: Observational

Funder types: Other

Identifiers

NCT01448590

SHSC-Haslam-PDPH

Details and patient eligibility

About

Epidural anesthesia is associated with potential risks and complications, post dural puncture headache (PDPH) one of the most recognized with epidural or spinal anesthesia. Accidental dural punctures occur with approximately 1.5% of all epidural attempts. Studies have suggested that the use of an intrathecal catheter reduces the incidence of PDPH. A systematic review of the existing literature will identify if there is reliable evidence to support this theory. A secondary outcome, headache severity, will also be explored via incidence rates of epidural blood patch, as this intervention is performed as a treatment for the most severe headaches.

Full description

Post dural puncture headache (PDPH) is one of the recognized complications experienced with epidural or spinal anesthesia, resulting from needle puncture of the dura layer of the meninges. This puncture can be deliberate (during spinal anesthesia) or accidental (during epidural anesthesia). Dural punctures allow a leak of cerebrospinal fluid, leading to the characteristic syndrome of PDPH; also known as a spinal headache or low-pressure headache. Accidental dural punctures occur with approximately 1.5% of all epidural attempts. Studies have estimated that, within the obstetrical population, headaches resulting from an inadvertent dural puncture are as high as 50% to 75%.

As the risk of accidental dural punctures (ADP) cannot be eliminated, research has focused on possible interventions that may be taken in order to avoid the onset of a PDPH, eliminate its severity, or treat effects. One of the most common and effective treatments being an epidural blood patch (EBP). More recently, threading the epidural catheter directly into the intrathecal space after the dural puncture has been recognized as a viable option.

Sex: Female

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• any comparative methodology, including case-control studies, cohort studies, randomized clinical trials, and chart reviews.
• Insertion of the epidural catheter into the intrathecal space at the level of dural puncture, was compared to resiting an epidural catheter at another level

Exclusion criteria

• Any intentional dural punctures (spinal anesthesia) or use of spinal microcatheters were excluded

Trial design

0 participants in 2 patient groups

Epidural Resite

Description:

After ADP, those patients who receive an epidural resite.

Spinal catheter

Description:

After ADP, those who receive the epidural catheter into the spinal space