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Post Dural Puncture Headache, Managed with Epidural Blood Patch, Is Associated with Subsequent Chronic Low Back Pain in Patients: a Pilot Study

  • Other Pain (AD Kaye, Section Editor)
  • Published:
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Abstract

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.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA

    Ivan Urits, Viet Cai, Musa Aner, Thomas Simopoulos, Vwaire Orhurhu, Jyotsna Nagda, Philip E. Hess & Jatinder Gill

  2. Valley Anesthesiology and Pain Consultants, Phoenix – Envision Physician Services, Phoenix, AZ, USA

    Omar Viswanath

  3. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

  4. University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  5. Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA, USA

    Alan D. Kaye

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  1. Ivan Urits
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  2. Viet Cai
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  7. Omar Viswanath
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  8. Alan D. Kaye
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  9. Philip E. Hess
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  10. Jatinder Gill
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Correspondence to Ivan Urits.

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Conflict of Interest

Ivan Urits, Viet Cai, Musa Aner, Thomas Simopoulos, Vwaire Orhurhu, Jyotsna Nagda, Omar Viswanath, Alan D. Kaye, Philip E. Hess and Jatinder Gill declare no conflict of interest.

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Urits, I., Cai, V., Aner, M. et al. Post Dural Puncture Headache, Managed with Epidural Blood Patch, Is Associated with Subsequent Chronic Low Back Pain in Patients: a Pilot Study. Curr Pain Headache Rep 24, 1 (2020). https://doi.org/10.1007/s11916-020-0834-5

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  • DOI: https://doi.org/10.1007/s11916-020-0834-5

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