Post dural puncture headache (PDPH) – conventional medical treatment versus epidural blood-patch (EBP)

Abstract

Aim. The post dural puncture headache (PDPH) represents a complication of spinal anaesthesia with an increased incidence in obstetric patients. The aim of our study, in which we included obstetric and non- obstetric patients with PDPH, was to evaluate the efficacy of the epidural blood-patch versus the conventional medical treatment.

Method. After written consent, 32 patients with PDPH were randomly divided into two groups: group A (16 patients) who received a conventional treatment (oral and i.v. hydration, NSAIDs, coffeine) and group B (16 patients) in whom an epidural blood patch was performed. The intensity of headache was evaluated using a visual analogue scale (VAS) from 0 to 5, before and two hours after the dural puncture. The results were analyzed statistically, with a value of p<0.05 considered significant.

Results. There were no statistical differences between the groups concerning the demographic data and the cause of PDPH. The intensity of PDPH was similar (4.1 in group A and 4.0 in group B on VAS). After treatment, the intensity of the headache diminished significantly in patients with epidural blood patch (VAS 0.5), comparatively with those with the conventional treatment (VAS 4.1). The same difference was recorded after 24 hours: VAS 0.35 in group B versus VAS 3.9 in group A.

Conclusions. The epidural blood patch represents a first choice treatment of PDPH, significantly superior to the conventional treatment.

Key words: postdural puncture headache, blood patch

Jurnalul Român de Anestezie Terapie intensivă 2002 Vol.9 Nr.2, 101-105

STUDII CLINICE

Cefaleea post puncţie durală (CPPD): tratament medicamentos versus „blood patch” peridural (BPP)