Subarachnoid Catheter Placement After Wet Tap for Analgesia in Labor: Influence on the Risk of Headache in Obstetric Patients. Issue 6 (1st November 2003)

• Record Type: Journal Article
• Authors: Ayad, Sabry; Demian, Yousef; Narouze, Samer N; Tetzlaff, John E
• Is Part Of: Regional anesthesia and pain medicine. Volume 28:Issue 6(2003)
• Page Start: 512
• Page End: 515
• Publication Date: 2003-11-01
• Subjects: Anesthesia -- Epidural -- Wet tap -- Postdural puncture headache -- Subarachnoid catheter; Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1016/S1098-7339(03)00393-6
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and Objectives: The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the incidence of PDPH. Methods: Over a 5-year interval, 115 consecutive patients who had unintentional dural puncture were divided into 3 groups by consecutive assignment. Group A had an epidural catheter placed at another interspace. Group B had a subarachnoid catheter placed for labor analgesia that was removed immediately after delivery. Group C had a subarachnoid catheter that was left in place for 24 hours after delivery. Data were collected retrospectively. The incidence of PDPH and blood patch was compared between groups. Results: The overall incidence of PDPH was 46.9% and need for blood patch 36.5%, significantly less in both subarachnoid catheter groups, 31% in B and 3% in group C, compared with group A (PDPH 81%) ( P < .001). Conclusion: Subarachnoid catheter placement after wet tap in obstetric patients reduces the PDPH rate and does so to a greater extent if left in place for 24 hours after delivery.