Optic nerve sheath diameter as a real-time biomarker for epidural blood patch efficacy after post-dural puncture headache: a preliminary report
Authors' conclusion
These preliminary findings suggest that ONSD ultrasound may offer a feasible, noninvasive adjunct for assessing early EBP response in PDPH.
Study context
- Population
- Postpartum patients with post-dural puncture headache (PDPH) after epidural anesthesia undergoing epidural blood patch (EBP)
- Participants
- 30 patients
- Outcome
- Correlation between change in ultrasound optic nerve sheath diameter (ONSD) (ΔONSD) and change in VAS pain score (ΔVAS) after EBP
- Follow-up
- Before (H0) and 2 h after (H2) EBP
Methodological detailssingle-center, preliminary report, bootstrap validation
- Single-center
- Preliminary report
- Bootstrap validation
Main finding
As reported in the abstract
ΔONSD and its correlation with pain reduction · 2 h after EBP
Correlation of ΔONSD with pain reduction (r)
r = - 0.64, p < 0.001; bootstrap 95% CI: −0.81 to - 0.36
Observational data: associations, not effects.
Further findings
ROC analysis of ΔONSD for early improvement
- AUC
- 0.96, 95% CI: 0.87-1.00
- Sensitivity at ΔONSD ≥ 0.40 mm threshold
- 100%
- Specificity at ΔONSD ≥ 0.40 mm threshold
- 83%
Original publication
Optic nerve sheath diameter as a real-time biomarker for epidural blood patch efficacy after post-dural puncture headache: a preliminary report. J Clin Monit Comput. Published 5 February 2026. doi:10.
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