POST-DURAL PUNCTURE HEADACHE IN SPINAL ANESTHESIA: A LITERATURE REVIEW ON INCIDENCE, RISK FACTORS AND MANAGEMENT STRATEGIES
DOI:
https://doi.org/10.47820/recima21.v5i6.5321Keywords:
Postdural puncture headache. Spinal anesthesia. Incidence, risk factors. Management strategies.Abstract
Post dural puncture headache (PDPH) is a common and debilitating complication following spinal anesthesia, negatively impacting patient recovery and increasing healthcare costs. Objective: This literature review aims to address the incidence, risk factors and management strategies of PDPH in patients undergoing spinal anesthesia. Methods: This literature review was conducted through a systematic search of scientific literature published in the last 15 years, covering the period from 2009 to 2024, in the PubMed, Web of Science, Scopus and Google Scholar databases. The inclusion criteria were original studies and reviews, in English, Portuguese or Spanish, which investigated intervention strategies for PDPH. Case reports, editorials and studies focused on other medical conditions were excluded. Results and Discussion: The incidence of PDPH ranges from 0.1% to 36% and is influenced by the anesthetic technique and patient characteristics. Risk factors include age, female gender and pregnancy. The choice of smaller-gauge, pencil-point needles reduces the incidence of PDPH. Ultrasound-guided puncture techniques minimize traumatic punctures. Conservative management, including hydration and the use of analgesics, is effective in mild cases. Epidural blood patch is the gold standard treatment for severe cases, while caffeine derivatives are a promising alternative. Conclusion: This review highlights the importance of a multifaceted approach to the prevention and management of PDPH, integrating evidence-based practices, continuing education of healthcare professionals and ongoing research.
Downloads
References
ABRAMS, Winfred B. et al. Management of cervical post–dural puncture headache. Pain Medicine, v. 21, n. 12, p. 3715-3718, 2020. DOI: https://doi.org/10.1093/pm/pnaa298
AL-HASHEL, Jasem et al. Post‐dural puncture headache: a prospective study on incidence, risk factors, and clinical characterization of 285 consecutive procedures. BMC neurology, v. 22, n. 1, p. 261, 2022. DOI: https://doi.org/10.1186/s12883-022-02785-0
ALI, Hassan Mohamed; MOHAMED, Mohamed Yehya; AHMED, Yahya Mohamed. Postdural puncture headache after spinal anesthesia in cesarean section: Experience in six months in 2736 patients in Kasr El aini teaching hospital–Cairo University. Egyptian Journal of Anaesthesia, v. 30, n. 4, p. 383-386, 2014. DOI: https://doi.org/10.1016/j.egja.2014.06.001
AMINI, Nazanin et al. The effect of sumatriptan, theophylline, pregabalin and caffeine on prevention of headache caused by spinal anaesthesia (PDPH): a systematic review. Journal of West African College of Surgeons, v. 12, n. 4, p. 102-116, 2022. DOI: https://doi.org/10.4103/jwas.jwas_183_22
AREVALO-RODRIGUEZ, Ingrid et al. Posture and fluids for preventing post‐dural puncture headache. Cochrane Database of Systematic Reviews, n. 3, 2016. DOI: https://doi.org/10.1002/14651858.CD009199.pub3
ASMARE, Mekuanint; EWNETU, Liyew; GETA, Kumlachew. Epidural blood patch in the treatment of severe post dural puncture headache after spinal anesthesia: A rare case report. International Journal of Surgery Case Reports, v. 95, p. 107256, 2022. DOI: https://doi.org/10.1016/j.ijscr.2022.107256
BANDATMAKUR, Madhav et al. Factors predisposing to post dural puncture headache in children. Journal of Child Neurology, v. 36, n. 10, p. 831-840, 2021. DOI: https://doi.org/10.1177/08830738211007699
BUDDEBERG, Bigna S.; BANDSCHAPP, Oliver; GIRARD, Thierry. Post-dural puncture headache. Minerva anestesiologica, v. 85, n. 5, p. 543-553, 2019. DOI: https://doi.org/10.23736/S0375-9393.18.13331-1
CASTRILLO, Ana et al. Postdural puncture headache: impact of needle type, a randomized trial. The spine journal, v. 15, n. 7, p. 1571-1576, 2015. DOI: https://doi.org/10.1016/j.spinee.2015.03.009
CHEKOL, Basazinew; YETNEBERK, Tikuneh; TESHOME, Diriba. Prevalence and associated factors of post dural puncture headache among parturients who underwent cesarean section with spinal anesthesia: A systemic review and meta-analysis, 2021. Annals of Medicine and Surgery, v. 66, p. 102456, 2021. DOI: https://doi.org/10.1016/j.amsu.2021.102456
DELPIZZO, Kathryn et al. Post-dural puncture headache is uncommon in young ambulatory surgery patients. HSS Journal®, v. 13, n. 2, p. 146-151, 2017. DOI: https://doi.org/10.1007/s11420-017-9541-0
GIRMA, Timsel et al. Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study. Annals of Medicine and Surgery, v. 78, 2022. DOI: https://doi.org/10.1016/j.amsu.2022.103729
KADDOUM, Roland et al. Accidental dural puncture, postdural puncture headache, intrathecal catheters, and epidural blood patch: revisiting the old nemesis. Journal of anesthesia, v. 28, p. 628-630, 2014. DOI: https://doi.org/10.1007/s00540-013-1761-y
MARANHAO, B. et al. The association between post‐dural puncture headache and needle type during spinal anaesthesia: a systematic review and network meta‐analysis. Anaesthesia, v. 76, n. 8, p. 1098-1110, 2021. DOI: https://doi.org/10.1111/anae.15320
MASHOUR, George A.; ENGELHARD, Kristin (Ed.). Oxford textbook of neuroscience and anaesthesiology. Oxford: Oxford University Press, 2019. DOI: https://doi.org/10.1093/med/9780198746645.001.0001
MATTURU, Soumya et al. Continuous Spinal Anesthesia Technique After Accidental Dural Puncture. Cureus, v. 14, n. 9, 2022. DOI: https://doi.org/10.7759/cureus.29046
MOORE, Albert R.; WIECZOREK, Paul M.; CARVALHO, Jose CA. Association between post–dural puncture headache after neuraxial anesthesia in childbirth and intracranial subdural hematoma. JAMA neurology, v. 77, n. 1, p. 65-72, 2020. DOI: https://doi.org/10.1001/jamaneurol.2019.2995
MOWAFY, Sherif MS; ELLATIF, Shereen E. Abd. Effectiveness of nebulized dexmedetomidine for treatment of post-dural puncture headache in parturients undergoing elective cesarean section under spinal anesthesia: a randomized controlled study. Journal of anesthesia, v. 35, p. 515-524, 2021. DOI: https://doi.org/10.1007/s00540-021-02944-6
OBERHOFER, Dagmar et al. Incidence and clinical significance of post-dural puncture headache in young orthopaedic patients and parturients. Periodicum biologorum, v. 115, n. 2, p. 203-208, 2013.
OKPALA, Boniface Chukwuneme et al. A double-blind placebo controlled trial on effectiveness of prophylactic dexamethasone for preventing post-dural puncture headache after spinal anesthesia for cesarean section. The Journal of Maternal-Fetal & Neonatal Medicine, v. 35, n. 17, p. 3407-3412, 2022. DOI: https://doi.org/10.1080/14767058.2020.1818719
ONA, Xavier Basurto et al. Drug therapy for preventing post‐dural puncture headache. Cochrane Database of Systematic Reviews, n. 2, 2013. DOI: https://doi.org/10.1002/14651858.CD001790.pub2
ORBACH‐ZINGER, S. et al. Intrathecal catheter use after accidental dural puncture in obstetric patients: literature review and clinical management recommendations. Anaesthesia, v. 76, n. 8, p. 1111-1121, 2021. DOI: https://doi.org/10.1111/anae.15390
OUMER, Keder Essa et al. Incidence and associated factors of post-dural puncture headache among orthopaedic patients after spinal anesthesia: a prospective cohort study. Annals of Medicine and Surgery, v. 85, n. 10, p. 4703-4708, 2023. DOI: https://doi.org/10.1097/MS9.0000000000001167
ÖZCENGIZ, Dilek (Ed.). Güncel Anesteziyoloji ve Ağrı Çalışmaları IV. Akademisyen Kitabevi, 2021. DOI: https://doi.org/10.37609/akya.637
PATEL, Riki et al. A comprehensive update on the treatment and management of postdural puncture headache. Current pain and headache reports, v. 24, p. 1-9, 2020. DOI: https://doi.org/10.1007/s11916-020-00860-0
SCHMITTNER, Marc D. et al. High incidence of post-dural puncture headache in patients with spinal saddle block induced with Quincke needles for anorectal surgery: a randomised clinical trial. International journal of colorectal disease, v. 25, p. 775-781, 2010. DOI: https://doi.org/10.1007/s00384-010-0888-7
SCHYNS-VAN DEN BERG, Alexandra MJV; GUPTA, Anil. Postdural puncture headache: Revisited. Best Practice & Research Clinical Anaesthesiology, v. 37, n. 2, p. 171-187, 2023. DOI: https://doi.org/10.1016/j.bpa.2023.02.006
SIEGLER, Benedikt Hermann et al. Postpunktionskopfschmerz in der Geburtshilfe. Die Anaesthesiologie, v. 71, n. 8, p. 646-660, 2022. DOI: https://doi.org/10.1007/s00101-022-01171-2
SONG, J. et al. Impact of obesity on post-dural puncture headache. International journal of obstetric anesthesia, v. 30, p. 5-9, 2017. DOI: https://doi.org/10.1016/j.ijoa.2016.10.009
SYED, Sumaya et al. Comparison of post-dural puncture headache-incidence and severity in obstetric patients after spinal anesthesia for caesarean section with 25G and 27G quincke needle. Int J Res Med Sci, v. 5, n. 2, p. 596-600, 2017. DOI: https://doi.org/10.18203/2320-6012.ijrms20170158
UPPAL, Vishal et al. Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group. Regional Anesthesia & Pain Medicine, 2023. DOI: https://doi.org/10.1136/rapm-2023-104817
WROBEL, Marc; VOLK, Thomas. Post-dural puncture headache. Anesthesiology and Pain Medicine, v. 1, n. 4, p. 273-274, 2012. DOI: https://doi.org/10.5812/aapm.3610
YOUSSEF, Hamdy Abbas et al. Sphenopalatine ganglion versus greater occipital nerve blocks in treating post-dural puncture headache after spinal anesthesia for cesarean section: A randomized clinical trial. Pain Physician, v. 24, n. 4, p. E443-E51, 2021. DOI: https://doi.org/10.36076/ppj.2021.24.E443
ZEGER, Wesley; YOUNGGREN, Bradley; SMITH, Lynette. Comparison of cosyntropin versus caffeine for post-dural puncture headaches: a randomized double-blind trial. World journal of emergency medicine, v. 3, n. 3, p. 182, 2012. DOI: https://doi.org/10.5847/wjem.j.issn.1920-8642.2012.03.004
ZETLAQUI, Paul J.; BUCHHEIT, Thomas; BENHAMOU, Dan. Epidural blood patch: A narrative review. Anaesthesia Critical Care & Pain Medicine, v. 41, n. 5, p. 101138, 2022. DOI: https://doi.org/10.1016/j.accpm.2022.101138
ZORRILLA-VACA, Andres; HEALY, Ryan; ZORRILLA-VACA, Carolina. Finer gauge of cutting but not pencil-point needles correlate with lower incidence of post-dural puncture headache: a meta-regression analysis. Journal of anesthesia, v. 30, p. 855-863, 2016. DOI: https://doi.org/10.1007/s00540-016-2221-2
Downloads
Published
License
Copyright (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
