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Subdural Hematoma Associated With Labor Epidural Analgesia: A Case Series

Lim, G.; Zorn, J.M.; Dong, Y.J.; DeRenzo, J.S.; Waters, J.H.

doi: 10.1097/01.aoa.0000521268.10760.69
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(Reg Anesth Pain Med 2016;41(5):628–631)

Subdural hematoma (SDH) is a rare but potentially serious adverse outcome following neuraxial analgesia. A wide differential diagnosis complicates the issue but SDH, especially after labor epidural analgesia, is more common than historically estimated. This case series estimated the rate of SDH after labor epidural at 0.026% or 1:3900 rather than the 1:250,000 to 1:500,000 estimated from previously published data. In addition, if a dural puncture occurs at the time of epidural placement the rate was estimated to be as high as 1.1% or 1:87. Thus, a postdural puncture headache (PDPH) following a neuraxial procedure must be monitored closely to avoid this complication and/or an incorrect diagnosis.

Department of Anesthesiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA

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