Purpose of Review

Post dural puncture headache (PDPH) is a relatively common complication which may occur in the setting of inadvertent dural puncture (DP) during labor epidural analgesia and during intentional DP during spinal anesthetic placement or diagnostic lumbar puncture. Few publications have established the long-term safety of an epidural blood patch (EBP) for the treatment of a PDPH.

Recent Findings

The aim of this pilot study was to examine the association of chronic low back pain (LBP) in patients who experienced a PDPH following labor analgesia and were treated with an EBP. A total of 146 patients were contacted and completed a survey questionnaire via telephone. The EBP group was found to be more likely to have chronic LBP (percentage difference 20% [95% CI 6–33%], RR 2.6 [95% CI 1.3–5.2]) and also LBP < 6 (percentage difference 24% [95% CI 9– 37%], RR 2.3 [95% CI 1.3–4.1]). There were no significant differences in the severity and descriptive qualities of pain between the EBP and non-EBP groups.

Summary

Our findings suggest that PDPH treated with an EBP is associated with an increased prevalence of subsequent low back pain in parturients. The findings of this pilot study should spur further prospective research into identifying potential associations between DP, EBP, and chronic low back pain.

中文翻译：

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硬膜外穿刺修补治疗的硬脑膜穿刺后头痛与患者随后的慢性腰背痛相关：一项先导研究。

审查目的

硬脑膜穿刺后头痛（PDPH）是一种相对常见的并发症，可能发生在硬膜外分娩镇痛期间无意穿刺硬膜穿刺（DP）的情况下，以及在麻醉剂放置或诊断性腰椎穿刺期间故意进行DP的情况下。很少有出版物确定硬膜外补血片（EBP）用于治疗PDPH的长期安全性。

最近的发现

这项前瞻性研究的目的是检查分娩镇痛后经历PDPH并接受EBP治疗的患者的慢性腰背痛（LBP）的相关性。总共联系了146位患者，并通过电话填写了调查问卷。发现EBP组更有可能患有慢性LBP（百分比差异20％[95％CI 6–33％]，RR 2.6 [95％CI 1.3–5.2]）以及LBP <6（百分比差异24％[ 95％CI 9–37％]，RR 2.3 [95％CI 1.3–4.1]）。在EBP组和非EBP组之间，疼痛的严重程度和描述质量没有显着差异。

概要

我们的发现表明，用EBP治疗的PDPH与产妇随后发生的下腰痛的患病率增加有关。这项前瞻性研究的结果将刺激进一步的前瞻性研究，以发现DP，EBP和慢性下腰痛之间的潜在关联。