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Curr Pain Headache Rep. 2020 Jan 8;24(1):1. doi: 10.1007/s11916-020-0834-5.

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

Author information

1
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA. iurits@bidmc.harvard.edu.
2
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
3
Valley Anesthesiology and Pain Consultants, Phoenix - Envision Physician Services, Phoenix, AZ, USA.
4
Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA.
5
University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
6
Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA, USA.

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 <‚ÄČ6 (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. 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.

KEYWORDS:

Chronic low back pain; Dural puncture; Epidural blood patch; Labor analgesia; Parturient; Post dural puncture headache

PMID:
31916041
DOI:
10.1007/s11916-020-0834-5

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