López Correa T, Garzón Sánchez J C, Sánchez Montero F J, Muriel Villoria C
Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Salamanca.
Rev Esp Anestesiol Reanim. 2011 Nov;58(9):563-73. doi: 10.1016/s0034-9356(11)70141-4.
Postdural puncture headache is the most common major complication following neuraxial anesthesia; this adverse event is particularly frequent in obstetrics. The headache is usually benign and self-limited but if left untreated can lead to more serious complications that may be life-threatening. Many treatments and prophylactic measures have been suggested, but evidence supporting them is scarce in many cases. After accidental dural puncture the only effective preventive measure is to leave the catheter inside the dura; epidural morphine infusion may also help. Once symptoms begin, treatment is conservative for the first 24 hours. If this approach fails, the most effective intervention continues to be a blood patch, which should not be delayed beyond 24 to 48 hours in order to avoid suffering. If more blood patches are required, other possible causes of headache should be ruled out.
