Incidence and management of accidental dural puncture and postdural puncture headache in parturients: Retrospective database study
Authors' conclusion
In our cohort, 13.3% of ADP cases were detected postpartum, posing an increased challenge and underscoring the critical importance of follow-up care.
Study context
- Population
- Adult parturients after neuraxial block with postdural puncture headache (PDPH) or reported accidental dural puncture (ADP), tertiary hospital, January 2017 to April 2022PDPH or reported ADP
- Participants
- 311 participants
- Outcome
- Rates of PDPH and ADP following introduction of a real-time documentation system (April 2018)
Methodological detailssingle tertiary hospital
- Single tertiary hospital
Main finding
As reported in the abstract
Rates of PDPH and ADP
Overall PDPH rate
0.4%
164/39888; 95% CI 0.0036 to 0.0049
Overall ADP rate
0.9%
284/31635; 95% CI 0.0078 to 0.0099
PDPH rate, real-time documentation period
0.44%
157/35376; 95% CI 0.0038 to 0.0052
ADP rate, real-time documentation period
0.99%
279/28121; 95% CI 0.0088 to 0.0111
Observational data: associations, not effects.
Secondary outcomes
Type of dural puncture among cases
- Intentional dural puncture (IDP), 32 cases
- 10.3%
- ADP, 279 cases
- 89.7%
Timing of ADP identification (279 ADP cases)
- Identified during the procedure
- 76.3%
- Suspected
- 10.4%
- Identified postpartum
- 13.3%
- ED visits, ADP identified postpartum
- 19%
Epidural blood patch (EBP)
- EBP administered in PDPH cases
- 72%
- First-time EBP success rate
- 89.5%
- Women receiving EBP after IDP
- 11
Original publication
Incidence and management of accidental dural puncture and postdural puncture headache in parturients: Retrospective database study. Eur J Anaesthesiol. Published 12 February 2025. doi:10.
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