Management of Post Dural Puncture Headache: An Evidence-Based Approach

Lisa Sangkum; Prateep Lertmongkonaksorn

doi:10.14456/rmj.2018.8

Authors

Lisa Sangkum Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Prateep Lertmongkonaksorn Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.14456/rmj.2018.8

Keywords:

Postdural puncture headache, Neuraxial anesthesia, Fisk factors, Management of postdural puncture headache

Abstract

Post dural puncture headache (PDPH) is one of the most common adverse events after neuraxial anesthesia. Typical symptoms of PDPH presents with worsening headache within 20 seconds after standing and resolving within 20 seconds of recumbency. PDPH can cause significant morbidity and mortality such as prolonged hospital stay, chronic headache or subdural hematoma. Since lot of treatments, such as cosyntropin or sphenopalatine ganglion block, has been proven to decrease the incidence of PDPH and rate of epidural blood patch (EBP). Therefore, this article aims to review current state of knowledge in this area and proposes an evidence-based practice guidance in term to manage when PDPH occurs.

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