Post Dural Puncture Headache in Obstetric Patients: A Review Article

Abstract

PDPH is the most common complication occurring after the neuraxial blocks.

The known risk factors are young age, female, obstetrics patients, multiple attempts during the procedure, inexpert operators,needle size, type and bevel orientation of the cutting needle expose the patient to high incidence of PDPH.

Diagnosis of PDPH can be confirmed with history of Postural component of the headache as aggravated in the sitting and standing position and relived in the supine lying posture. Refractory to routine analgesia and a witness of theDural puncture from the available record of the procedure notes.

The possible mechanism is CSF leakage through the puncture site.

Conservative management such as bed rest, adequate hydration, carbonated drinks, caffeine, dexamethasone, paracetamol, NSAIDS and narcotics are used by different anaesthetist with their own preferences and the Epidural blood patch is the definitive treatment for PDPH.

This article reviews the current literature on the clinical diagnosis, risk factors, pathophysiology and definitive treatment of PDPH.