Anesthesia and Analgesia: Regional AnalgesiaThe Association Between Labor Epidural Case Volume and the Rate of Accidental Dural PunctureSidhu, N.S.; Cavadino, A.; Ku, H.; Kerckhoffs, P.; Lowe, M. Author Information Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand Obstetric Anesthesia Digest: September 2022 - Volume 42 - Issue 3 - p 146-147 doi: 10.1097/01.aoa.0000853636.97214.9e Buy Metrics Abstract (Anaesthesia. 2021;76:1060–1067) Labor analgesia accomplished with epidural catheter placement can be complicated by accidental dural puncture (ADP), with recent reported rates at obstetric centers ranging from 0.52% to 3.6%. The incidence of postdural puncture headache following ADP is frequent and can be severe and debilitating. The assumption that ADP rate is higher among trainees compared with specialists has opposing data in the literature, which analysis may have been confounded by a factor of skill decay. This study examined the effect of decreased labor epidural volume and skill decay on ADP rate and the effect of training grade among anesthesia trainees on likelihood of ADP. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.