Prophylactic cosyntropin after unintentional dural puncture and incidence of post-dural puncture headache and epidural blood patch use: A retrospective cohort study (2019–2022)
Authors' conclusion
Prophylactic cosyntropin following UDP was not associated with a significant decrease in PDPH rate or use of epidural blood patch for management of PDPH.
Study context
- Population
- Cases with unintentional dural puncture during placement of neuraxial labor analgesiacases with unintentional dural puncture (UDP)
- Participants
- 234 cases
- Exposure
- Cosyntropin vs No cosyntropin
- Cosyntropinn = 164
- No cosyntropinn = 70reference
- Outcome
- Incidence of PDPH
Main finding
PDPH
Adjusted difference
9%
95% CI −6% to 24%
P = 0.25
Events by group
Cosyntropin vs No cosyntropin
adjusted difference 9% (95% CI −6% to 24%); P = 0.25
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Cosyntropin | No cosyntropin | Difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Epidural blood patch use (adjusted rate) | 66% | 78% | 12% (−5% to 28%) | P = 0.17 | |
| −2002040Difference (linear scale) |
Safety
Adverse hyperglycemic or hypertensive events
- No significant difference with vs without cosyntropin
Original publication
Prophylactic cosyntropin after unintentional dural puncture and incidence of post-dural puncture headache and epidural blood patch use: A retrospective cohort study (2019–2022). Int J Obstet Anesth. Published 30 August 2024. doi:10.
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