A ten-year retrospective study of post-dural puncture headache in 32,655 obstetric patients
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REPORTS OF ORIGINAL INVESTIGATIONS
A ten-year retrospective study of post-dural puncture headache in 32,655 obstetric patients Une e´tude re´trospective de dix ans sur les ce´phale´es post-ponction de la dure-me`re aupre`s de 32 655 patientes obste´tricales Ana C. Costa, MD . James R. Satalich, BS . Ehab Al-Bizri, MD . Shivam Shodhan, MD . Jamie L. Romeiser, MPH . Rishimani Adsumelli, MD . Ramon E. Abola, MD . Ellen S. Steinberg, MD . Elliott Bennett-Guerrero, MD Received: 18 January 2019 / Revised: 14 June 2019 / Accepted: 14 June 2019 Ó Canadian Anesthesiologists’ Society 2019
Abstract Purpose Accidental dural puncture and post-dural puncture headache are well-known complications of neuraxial anesthesia in parturients. The primary goal of this study was to identify the rate of post-dural puncture headache and epidural blood patch in all parturients who received a neuraxial anesthetic during a ten-year period at an academic tertiary-care medical centre. A secondary goal was to identify any delay in hospital discharge due to a post-dural puncture headache. Methods We conducted a retrospective analysis of all patients who received a neuraxial anesthetic on the labour and delivery unit at Stony Brook Medical Center from 1 January, 2006 to 31 December, 2015. Standardized neuraxial anesthesia equipment was used throughout this period. Chart reviews were conducted on all patients who received a neuraxial anesthetic and had an accidental
A. C. Costa, MD (&) Department of Anesthesiology, Stony Brook Medical Center, Stony Brook, NY, USA e-mail: [email protected] Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY 11794-8480, USA J. R. Satalich, BS Virginia Commonwealth University School of Medicine, Richmond, VA, USA E. Al-Bizri, MD S. Shodhan, MD J. L. Romeiser, MPH R. Adsumelli, MD R. E. Abola, MD E. S. Steinberg, MD E. Bennett-Guerrero, MD Department of Anesthesiology, Stony Brook Medical Center, Stony Brook, NY, USA
dural puncture and/or developed a post-dural puncture headache. Results Of the 32,655 neuraxial anesthetics performed, 298 (0.9%) patients experienced a post- dural puncture headache. Analysis of all patients who developed a postdural puncture headache showed that 150 (50.3%) patients received one or more epidural blood patches. Overall, 19 (0.06%) patients had a delay in hospital discharge due to a post-dural puncture headache. Conclusions We showed a relatively low incidence (\1%) of post-dural puncture headache following neuraxial anesthesia in parturients at an academic tertiary-care medical centre. Patients that rated their post-dural puncture headache as very severe were more likely to undergo at least one epidural blood patch procedure. Postdural puncture headache is a well-known complication of neuraxial anesthesia, and may lead to a delay in hospital discharge. Re´sume´ Objectif La ponction accidentelle de la dure-me`re et les ce´phale´es post-ponction dure-me´rienne (CPPD) sont des complications bien connues de l’anesthe´sie neuraxiale chez les partur
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