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1 results

  • Chapter 11 - Post-dural Puncture Headache

  • from Part III - Chronic Pain Conditions Head and Neck
  • Edited by Omar Viswanath, Creighton University, Omaha, Ivan Urits, Southcoast Brain & Spine Center, Wareham
  • Book:
    Cambridge Handbook of Pain Medicine
    Published online:
    01 December 2023
    Print publication:
    14 December 2023, pp 69-74

  • Summary

    Common adverse complication following dural puncture (DP) during epidural orspinal anesthesia which results in symptoms such as dull throbbing headache, fronto-occipital distribution, worse in seated position, alleviated when supine. Other symptoms include nausea, vomiting, neck stiffness, and tinnitus. Adverse event is seen commonly in patients receiving epidural or spinal neuraxial anesthesia, which occurs following inadvertent puncture of the dura. Conservative treatment is often adequate in majority of the patients, but medical management can be used liberally with a variety of safe, well-studied pharmacologic options. Epidural blood patch is the gold standard in treating unremitting PDPH but should be used cautiously due to the potential for rare but serious complications.