Improving the Management of Postdural Puncture Headache—An International Clinical Guideline and Call for Better Evidence
Year: 2023
Type: article
Abstract: Dural puncture can occur either as a planned procedure during routine clinical care or as an unexpected complication of neuraxial procedures.Fortunately, most individuals who undergo dural puncture, whether intentional or accidental, do not develop postdural puncture headaches.However, experiences of positional head pains, neck stiffness, and possibly hearing symptoms within a few days of the dural puncture suggest a diagnosis of postdural puncture headache.1 This condition warrants prompt diagnosis and appropriate management to alleviate the associated symptoms and discomfort.While postdural puncture headache may be a seemingly minor, resolvable complication to clinicians, to patients, these debilitating symptoms can lead to suffering and difficulty completing daily tasks and self-care.Postdural puncture headache may be particularly disruptive for postpartum patients who are both recovering from childbirth and taking on new roles as parents.Several postpartum people have presented their stories of postdural puncture headaches on the internet, such as Kayla Peloquin, who wrote about her experience in her blog.2 After an accidental dural puncture, she described the excruciating headache, the inability to sit up or care for her children, and the concern about taking medications while breastfeeding.She further described the poor communication among her health care team members, leading to a delay in ultimately receiving relief from a second blood patch.Her experience attests to both the harm from this complication and the need to better address it.This consensus statement from Uppal and colleagues 3 presents an important clinical guideline to improve the safety and care of patients at-risk or experiencing postdural puncture headache.These practice guidelines were developed by the American Society for Regional Anesthesia and Pain Medicine in collaboration with 5 other national and international professional societies, with representatives from North America and Europe specializing in anesthesiology, obstetrics, radiology, pain, and other relevant backgrounds.Experts answered 10 questions central to the management
Source: JAMA Network Open
Authors: Mark C. Bicket, Alex Peahl, Robert R. Gaiser
Institutions: University of Michigan, Michigan Medicine, Yale University
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
OpenAlex ID: W4385827809