Evaluation of Affecting Factors and The Effectiveness of Treatment in Cases With Post-Dural Puncture Headache Who Underwent Epidural Blood Patch

Lütfiye Pirbudak1, Mete Gurol Uğur2, Berna Kaya Uğur3, Seval Kul4, Süleyman Ganidağlı1

11. gaziantep University School Of Medicine, Department Of Anesthesiology And Reanimation, Department Algology
2Gaziantep University, School Of Medicine Department Of Obstetrics And Gynecology
3Gaziantep Childrens’ Hospital Department Of Anesthesiology And Reanimation.
4Gaziantep University, School Of Medicine, Department Of Biostatistics

Keywords: Post dural puncture headache (PDPH), Surgery;Epidural blood patch; Radicular pain

Abstract

Purpose: We evaluated post dural puncture headache (PDPH) cases, contributing factors, their treatment with epidural blood patch (EBP) and responses to the therapy.
Methods: In this retrospective study, 77 PDPH cases treated with EBP were included. Patients were evaluated in terms of age, gender, type of surgery, type and diameter of the needle used for dural puncture, number(s) of dural puncture, onset of punctural headache, any conservative therapies for PDPH, number(s) of EBP application, analgesia quality at 10th minute and 2nd hour after EBP application and radicular pain during procedure.
Results: Mean age of 77 patients (46 female, 31 male) was 31.5 ± 11.3, and most common surgery performed was cesarean section. More than one attempt were applied in 48 patients. In 37 cases 22G spinal needle, in 20 cases 25 G spinal needle were used. The mean duration of the headache was 3.1 ± 1.3 days for female patients and 4.6 ± 2.3 days for male patients (p=0.020). VAS significantly decreased and patient satisfaction significantly increased after the 10th minute in patients who had EBP (p=0.001). In only one case (2%) second EBP was needed for pain relief. Transient radicular pain was observed in 17 cases (22.07%) at administration of EBP
Conclusion: . In PDPH cases EBP is an effective and relatively safe method especially in obstetric patients. we reported that the PDPH symptoms were presented earlier in female patients. Preference of small diameter needles less than 22 G and avoiding multiple attempts may be elaborated for spinal anesthesia.