PMID: 20640074Feb 1, 2009Paper

Intrathecal Catheterization by Epidural Catheter: Management of Accidental Dural Puncture and Prophylaxis of PDPH.

Indian Journal of Anaesthesia
Ashok JadonRajiv Agrawal

Abstract

Accidental or inadvertent dural puncture during epidural anaesthesia results in high incidence of post dural puncture headache (PDPH). Spinal or intrathecal catheter in such a situation, provides a conduit for administration of appropriate local anaesthetic for rapid onset of intraoperative surgical anaesthesia and postoperative pain relief. This procedure prevents PDPH if catheter left in situ for > 24 hrs and also avoids the associated risks with a repeat attempts at epidural analgesia. Primary aim of this study was to observe the effect of spinal catheter on incidence of PDPH, and to assess early and delayed complications of spinal catheterization by epidural catheter. In prospective clinical study 34 patients who had accidental dural puncture during epidural anaesthesia were included. The catheter meant for epidural use was inserted in spinal space and used for spinal anaesthesia and postoperative analgesia. Catheter was removed between 24-36hrs after surgery. The incidence of accidental dural puncture was 4%(34/846). Two patients 5.88% (2/34) had transient paresthesia during spinal catheter insertion. Post dural puncture headache occurred in 11.76% (4/34) patients. Two patients required epidural blood patch and two patient...Continue Reading

References

Jan 16, 1998·Anesthesia and Analgesia·D H Lambert
Feb 18, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·K C Dennehy, O P Rosaeg
Mar 26, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·C W BergerW Grodecki
Aug 24, 2004·International Journal of Obstetric Anesthesia·T M L ChanUNKNOWN NOAD Steering Group
Aug 24, 2004·International Journal of Obstetric Anesthesia·S V RutterR Russell
Aug 24, 2004·International Journal of Obstetric Anesthesia·C M Cowan, E W Moore

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