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Insertion of an Intrathecal Catheter Following a Recognized Accidental Dural Puncture Reduces the Need for an Epidural Blood Patch in Parturients

An Australian Retrospective Study

Rana, K.; Jenkins, S.; Rana, M.

doi: 10.1097/01.aoa.0000575260.73885.cb
Anesthesia and Analgesia: Regional Analgesia

(Int J Obstet Anesth. 2018;36:11–16)

Postdural puncture headache (PDPH) is one of the most common complications associated with obstetric epidural analgesia, It can be particularly debilitating for new mothers who have to deal with the responsibilities of a newborn and can lead to longer hospital stays after delivery. In addition, some studies have reported that approximately one quarter of parturients who have a PDPH ultimately develop chronic headaches. While some have proposed inserting an intrathecal catheter (ITC) at the time of an accidental dural puncture (ADP) as a means of preventing PDPH and the need for an epidural blood patch (EBP), the efficacy of this management strategy remains unclear. There have been studies reporting a reduction in PDPH and EBP but others have not found these beneficial effects. This study aimed to investigate whether the insertion of an ITC after ADP reduced the rate of PDPH and need for EBP in obstetric patients. They also evaluated whether the length of time the ITC was in place (<24 or >24 h) affected the efficacy of the treatment.

Medical School, The University of Adelaide, Australia; Department of Anaesthesia, Lyell McEwin Hospital, Haydown Rd, Elizabeth Vale, South Australia, Australia

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