Management of Post Dural Puncture Headache: An Evidence-Based Approach
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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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Antunes MV, Moreira A, Sampaio C, Faria A. Accidental dural puncture and post-dural puncture headache in the obstetric population: eight years of experience. Acta Med Port. 2016;29(4):268-274. doi:10.20344/amp.6815.
Nishio I, Williams BA, Williams JP. Diplopia: a complication of dural puncture. Anesthesiology. 2004;100(1):158-164.
Zeidan A, Farhat O, Maaliki H, Baraka A. Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature. Int J Obstet Anesth. 2006;15(1):50-58.
Klarica M, Rados M, Erceg G, Petosic A, Jurjevic I, Oreskovic D. The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication. PLoS One. 2014;9(4):e95229. doi:10.1371/journal.pone.0095229.
Nguyen DT, Walters RR. Standardizing management of post-dural puncture headache in obstetric patients: a literature review. Open Journal of Anesthesiology. 2014;10(4):244-253. doi:10.4236/ojanes.2014.410037.
Ahmed SV, Jayawarna C, Jude E. Post lumbar puncture headache: diagnosis and management. Postgrad Med J. 2006;82(973):713-716. doi:10.1136/pgmj.2006.044792.
Hofer JE, Scavone BM. Cranial nerve VI palsy after dural-arachnoid puncture. Anesth Analg. 2015;120(3):644-646. doi:10.1213/ANE.0000000000000587.
Pogodzinski MS, Shallop JK, Sprung J, Weingarten TN, Wong GY, McDonald TJ. Hearing loss and cerebrospinal fluid pressure: case report and review of the literature. Ear Nose Throat J. 2008;87(3):144-147.
Bleeker CP, Hendriks IM, Booij LH. Postpartum post-dural puncture headache: is your differential diagnosis complete? Br J Anaesth. 2004;93(3):461-464.
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629-808. doi:10.1177/0333102413485658.
Davignon KR, Dennehy KC. Update on postdural puncture headache. Int Anesthesiol Clin. 2002;40(4):89-102.
Wadud R, Laiq N, Qureshi FA, Jan AS. The frequency of postdural puncture headache in different age groups. J Coll Physicians Surg Pak. 2006;16(6):389-392.
Gibson SJ, Helme RD. Age-related differences in pain perception and report. Clin Geriatr Med. 2001;17(3):433-456.
Wu CL, Rowlingson AJ, Cohen SR, et al. Gender and post-dural puncture headache. Anesthesiology. 2006;105(3):613-618.
Peralta F, Higgins N, Lange E, Wong CA, McCarthy RJ. The relationship of body mass index with the incidence of postdural puncture headache in parturients. Anesth Analg. 2015;121(2):451-456. doi:10.1213/ANE.0000000000000802.
Miu M, Paech MJ, Nathan E. The relationship between body mass index and post-dural puncture headache in obstetric patients. Int J Obstet Anesth. 2014;23(4):371-375. doi:10.1016/j.ijoa.2014.06.005.
Vallejo MC, Mandell GL, Sabo DP, Ramanathan S. Postdural puncture headache: a randomized comparison of five spinal needles in obstetric patients. Anesth Analg. 2000;91(4):916-920.
Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Can J Anaesth. 2003;50(5):460-469.
Bezov D, Lipton RB, Ashina S. Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology. Headache. 2010;50(7):1144-1152. doi:10.1111/j.1526-4610.2010.01699.x.
Calthorpe N. The history of spinal needles: getting to the point. Anaesthesia. 2004;59(12):1231-1241.
Arevalo-Rodriguez I, Munoz L, Godoy-Casasbuenas N, et al. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH). Cochrane Database Syst Rev. 2017;4:CD010807. doi:10.1002/14651858.CD010807.pub2.
Aida S, Taga K, Yamakura T, Endoh H, Shimoji K. Headache after attempted epidural block: the role of intrathecal air. Anesthesiology. 1998;88(1):76-81.
Yaksh TL, Noueihed RY, Durant PA. Studies of the pharmacology and pathology of intrathecally administered 4-anilinopiperidine analogues and morphine in the rat and cat. Anesthesiology. 1986;64(1):54-66.
Heesen M, Klohr S, Rossaint R, Walters M, Straube S, van de Velde M. Insertion of an intrathecal catheter following accidental dural puncture: a meta-analysis. Int J Obstet Anesth. 2013;22(1):26-30. doi:10.1016/j.ijoa.2012.10.004.
Russell IF. A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour. Int J Obstet Anesth. 2012;21(1):7-16. doi:10.1016/j.ijoa.2011.10.005.
Al-metwalli RR. Epidural morphine injections for prevention of post dural puncture headache. Anaesthesia. 2008;63(8):847-850. doi:10.1111/j.1365-2044.2008.05494.x.
Gaiser RR. Postdural puncture headache: an evidence-based approach. Anesthesiol Clin. 2017;35(1):157-167. doi:10.1016/j.anclin.2016.09.013.
Stein MH, Cohen S, Mohiuddin MA, Dombrovskiy V, Lowenwirt I. Prophylactic vs therapeutic blood patch for obstetric patients with accidental dural puncture--a randomised controlled trial. Anaesthesia. 2014;69(4):320-326. doi:10.1111/anae.12562.
Scavone BM, Wong CA, Sullivan JT, Yaghmour E, Sherwani SS, McCarthy RJ. Efficacy of a prophylactic epidural blood patch in preventing post dural puncture headache in parturients after inadvertent dural puncture. Anesthesiology. 2004;101(6):1422-1427.
Arevalo-Rodriguez I, Ciapponi A, Munoz L, Roque i Figuls M, Bonfill Cosp X. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2013;(7):CD009199. doi:10.1002/14651858.CD009199.pub2.
Naulty JS, Hertwig L, Hunt CO, Datta S, Ostheimer GW, Weiss JB. Influence of local anesthetic solution on postdural puncture headache. Anesthesiology. 1990;72(3):450-454.
Mosavy SH, Shafei M. Prevention of headache consequent upon dural puncture in obstetric patient. Anaesthesia. 1975;30(6):807-809.
Nehlig A, Daval JL, Debry G. Caffeine and the central nervous system: mechanisms of action, biochemical, metabolic and psychostimulant effects. Brain Res Brain Res Rev. 1992;17(2):139-170.
Zeger W, Younggren B, Smith L. Comparison of cosyntropin versus caffeine for post-dural puncture headaches: a randomized double-blind trial. World J Emerg Med. 2012;3(3):182-185. doi:10.5847/wjem.j.1920-8642.2012.03.004.
Camann WR, Murray RS, Mushlin PS, Lambert DH. Effects of oral caffeine on postdural puncture headache. A double-blind, placebo-controlled trial. Anesth Analg. 1990;70(2):181-184.
Cohen SM, Laurito CE, Curran MJ. Grand mal seizure in a postpartum patient following intravenous infusion of caffeine sodium benzoate to treat persistent headache. J Clin Anesth. 1992;4(1):48-51.
Cua WL, Pease Campbell JA, Stewart JT. A case of ventricular tachycardia related to caffeine pretreatment. J ECT. 2009;25(1):70-71. doi:10.1097/YCT.0b013e318178d969.
Humphrey PP, Goadsby PJ. The mode of action of sumatriptan is vascular? a debate. Cephalalgia. 1994;14(6):401-410.
Connelly NR, Parker RK, Rahimi A, Gibson CS. Sumatriptan in patients with postdural puncture headache. Headache. 2000;40(4):316-319.
Ghanei M, Rahmanian K, Jahromi A. S, Sahraei R. Effect of sumatriptan on postduural puncture headache. Biomed Pharmacol J. 2016;9(2):735-738. doi:10.13005/bpj/997.
Friedman BW, Greenwald P, Bania TC, et al. Randomized trial of IV dexamethasone for acute migraine in the emergency department. Neurology. 2007;69(22):2038-2044.
Yang B, Li DL, Dong P, Zhang XY, Zhang L, Yu JG. Effect of dexamethasone on the incidence of post-dural puncture headache after spinal anesthesia: a randomized, double-blind, placebo-controlled trial and a meta-analysis. Acta Neurol Belg. 2015;115(1):59-67. doi:10.1007/s13760-014-0307-x.
Alam MR, Rahman MA, Ershad R. Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache. J Anaesthesiol Clin Pharmacol. 2012;28(2):190-193. doi:10.4103/0970-9185.94840.
Carter BL, Pasupuleti R. Use of intravenous cosyntropin in the treatment of postdural puncture headache. Anesthesiology. 2000;92(1):272-274.
Hakim SM. Cosyntropin for prophylaxis against postdural puncture headache after accidental dural puncture. Anesthesiology. 2010;113(2):413-420. doi:10.1097/ALN.0b013e3181dfd424.
Yoon MH, Choi JI, Jeong SW. Spinal gabapentin and antinociception: mechanisms of action. J Korean Med Sci. 2003;18(2):255-261.
Nofal WH, Mahmoud MS, Al Alim AA. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia? Saudi J Anaesth. 2014;8(3):359-363. doi:10.4103/1658-354X.136433.
Taylor CP, Angelotti T, Fauman E. Pharmacology and mechanism of action of pregabalin: the calcium channel alpha2-delta (alpha2-delta) subunit as a target for antiepileptic drug discovery. Epilepsy Res. 2007;73(2):137-150.
Huseyinoglu U, Huseyinoglu N, Hamurtekin E, Aygun H, Sulu B. Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture. J Clin Neurosci. 2011;18(10):1365-1368. doi:10.1016/j.jocn.2011.02.029.
Agerson AN, Scavone BM. Prophylactic epidural blood patch after unintentional dural puncture for the prevention of postdural puncture headache in parturients. Anesth Analg. 2012;115(1):133-136. doi:10.1213/ANE.0b013e31825642c7.
Oedit R, van Kooten F, Bakker SL, Dippel DW. Efficacy of the epidural blood patch for the treatment of post lumbar puncture headache BLOPP: a randomised, observer-blind, controlled clinical trial [ISRCTN 71598245]. BMC Neurol. 2005;5(1):12.
Szeinfeld M, Ihmeidan IH, Moser MM, Machado R, Klose KJ, Serafini AN. Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology. 1986;64(6):820-822.
Paech MJ, Doherty DA, Christmas T, Wong CA; Epidural Blood Patch Trial Group. The volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial. Anesth Analg. 2011;113(1):126-133. doi:10.1213/ANE.0b013e318218204d.
Martin R, Jourdain S, Clairoux M, Tetrault JP. Duration of decubitus position after epidural blood patch. Can J Anaesth. 1994;41(1):23-25.
Sorour M, Krisht KM, Couldwell WT. Intraventricular hemorrhage after epidural blood patching: an unusual complication. Case Rep Neurol Med. 2014;2014:406289. doi:10.1155/2014/406289.
Matute E, Bonilla S, Girones A, Planas A. Bilateral greater occipital nerve block for post-dural puncture headache. Anaesthesia. 2008;63(5):557-558. doi:10.1111/j.1365-2044.2008.05531.x.
Tobin J, Flitman S. Occipital nerve blocks: when and what to inject? Headache. 2009;49(10):1521-1533. doi:10.1111/j.1526-4610.2009.01493.x.
Niraj G, Kelkar A, Girotra V. Greater occipital nerve block for postdural puncture headache (PDPH): a prospective audit of a modified guideline for the management of PDPH and review of the literature. J Clin Anesth. 2014;26(7):539-544. doi:10.1016/j.jclinane.2014.03.006.
Grosh T, Ayubcha D. Images in anesthesiology: modified cotton swab applicator for nasal sphenopalatine ganglion nerve block. Anesthesiology. 2018;128(1):140. doi:10.1097/ALN.0000000000001837.
Cohen S, Ramos D, Grubb W, Mellender S, Mohiuddin A, Chiricolo A. Sphenopalatine ganglion block: a safer alternative to epidural blood patch for postdural puncture headache. Reg Anesth Pain Med. 2014;39(6):563. doi:10.1097/AAP.0000000000000172.