The effect of placement and management of intrathecal catheters following accidental dural puncture on the incidence of postdural puncture headache and severity: a retrospective real‐world study
Authors' conclusion
Our study confirms the benefits of intrathecal catheterisation
Study context
- Population
- Parturients with accidental dural puncture during labour epidural analgesia, 2017–2022of 92,651 epidurals
- Participants
- 550 participants
- Exposure
- Intrathecal catheter vs resited epidural after accidental dural puncture
- Intrathecal cathetern = 219
- Resited epiduraln = 331reference
- Outcome
- Incidence of PDPH and need for epidural blood patch
Methodological detailstwo tertiary university-affiliated centres, real-world, Conducted 2017–2022 at two tertiary, university-affiliated centres
- Two tertiary university-affiliated centres
- Real-world
- Conducted 2017–2022 at two tertiary, university-affiliated centres
Main finding
As reported in the abstract
Intrathecal catheter vs Resited epiduralAdjusted odds ratio (95% CI)P value
PDPH; did not decrease odds
0.91(0.81–1.01)
Epidural blood patch
0.82(0.73–0.91)
P < 0.001Observational data: associations, not effects.
Further findings
PDPH: leaving in the intrathecal catheter for 24 h postpartum
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Leaving in the intrathecal catheter for 24 h postpartumNo benefit | 1.01 (1.00–1.02) | P = 0.015 | |
| 0.512Adjusted odds ratio (log scale) |
Epidural blood patch: leaving in the intrathecal catheter for 24 h postpartum
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Leaving in the intrathecal catheter for 24 h postpartumNo benefit | 1.00 (0.99–1.01) | P = 0.40 | |
| 0.512Adjusted odds ratio (log scale) |
PDPH: injecting intrathecal saline
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Injecting intrathecal saline | 0.85 (0.73–0.99) | P = 0.04 | |
| 0.512Adjusted odds ratio (log scale) |
Epidural blood patch: injecting intrathecal saline
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Injecting intrathecal saline | 0.75 (0.64–0.87) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
The effect of placement and management of intrathecal catheters following accidental dural puncture on the incidence of postdural puncture headache and severity: a retrospective real‐world study. Anaesthesia. Published 13 July 2023. doi:10.
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