Postdural puncture headache

Sohan Parekh; Andy Jagoda

doi:10.1017/CBO9780511544835.052

Postdural puncture headache

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

Abstract

This chapter discusses the role of caffeine, Gabapentin, and Epidural blood patch in postdural puncture headache. Postdural puncture headache (PDPH) complicates up to 5% of spinal taps and is also frequently seen postpartum (from anesthesia-related dural puncture). The best treatment for PDPH is prevention. Although a variety of approaches to PDPH have been mentioned in reviews, the drug therapy with the most supporting evidence is caffeine. Oral formulations of caffeine (300 mg per dose) are more effective than placebo for PDPH. Thrice-daily gabapentin is reported in case series to have efficacy in PDPH. The evidence is preliminary, but administration of this anticonvulsant is of potential utility when caffeine fails or is not an option, and patients are not candidates for (or refuse) epidural blood patch. The responsibility of the acute care provider to the patient with PDPH is often administration of temporizing pharmacotherapy pending availability of an epidural blood patch.

Original language	English
Title of host publication	Emergency Department Analgesia
Subtitle of host publication	An Evidence-Based Guide
Publisher	Cambridge University Press
Pages	351-353
Number of pages	3
ISBN (Electronic)	9780511544835
ISBN (Print)	9780521696012
DOIs	https://doi.org/10.1017/CBO9780511544835.052
State	Published - 1 Jan 2008

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Postdural puncture headache

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