Background: The post-dural puncture headache (PDPH) is a common complication in spinal anesthesia. Headache may occure seven days after dural puncture. The headache may be worsened in sitting position and be better in supine position. PDPH is common in younger and tall people. The incidence rate of PDPH related to the size of spinal needle and the number of try and decrease with small, cutting ...

We read with great interest study conducted by Mosaffa et al. (1), designed to compare the rate of post-dural puncture headache (PDPH) in median and paramedian approaches in spinal anesthesia in the September issue of Anesthesiology and Pain Medicine. Spinal anaesthesia has been used in patients from preterm neonates to aged over a hundred years. At present it is a gold standard for many differ...

We report the case of a 25-year-old woman, who received epidural analgesia for labour pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma....

Scoliosis is defined as lateral curvature of the spine. This condition is found in 2% of the population worldwide with a two-fold higher prevalence in women than in men [1]. The challenges faced by anesthesiologists in providing neuraxial analgesia for parturients with scoliosis are inability to identify the epidural space, multiple attempts before catheter insertion, long insertion time, patch...

The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac...

One hundred patients aged 18-49 yr, undergoing elective arthroscopy of the knee joint, were allocated randomly to either spinal anaesthesia using a 29-gauge spinal needle or general anaesthesia. Dural puncture was considered difficult in 18% of the patients receiving spinal anaesthesia. In three patients (6%) it was necessary to supplement the spinal anaesthetic with general anaesthesia. Spinal...

Use of an epidural blood patch to treat spinal headache after accidental dural puncture is well recognized. The high success rate associated with this practice has been questioned and it is not uncommon for patients to suffer recurring headaches after a supposedly successful blood patch. We describe a patient in labour who suffered accidental dural puncture, and whose headache was treated twice...