![]() The international working group guidelines proposed by Uppal and colleagues 3 appropriately recognize that the relevance of postdural puncture headache is by no means limited to the obstetric population and spans a greater diversity of patient populations, care environments, and clinical contexts.īeyond the obstetric population, notable numbers of patients may also encounter the risk of postdural puncture headache in diverse settings. As such, past guidelines have appropriately focused on data and evidence to guide care for individuals after birth. Indeed, more than 70% of the almost 4 million pregnant people who give birth each year in the United States receive neuraxial analgesia, and almost all of them are young and female, common risk factors for postdural puncture headache. ![]() Many clinicians consider postdural puncture headache as a complication most likely to arise within maternity wards. Experts answered 10 questions central to the management of postdural puncture headache, including 46 recommendations that outline a systematic approach to the prevention, diagnosis, and management of postdural puncture headache. These practice guidelines were developed by the American Society for Regional Anesthesia and Pain Medicine in collaboration with 5 other national and international professional societies, with representatives from North America and Europe specializing in anesthesiology, obstetrics, radiology, pain, and other relevant backgrounds. This consensus statement from Uppal and colleagues 3 presents an important clinical guideline to improve the safety and care of patients at-risk or experiencing postdural puncture headache. Her experience attests to both the harm from this complication and the need to better address it. She further described the poor communication among her health care team members, leading to a delay in ultimately receiving relief from a second blood patch. 2 After an accidental dural puncture, she described the excruciating headache, the inability to sit up or care for her children, and the concern about taking medications while breastfeeding. ![]() ![]() Several postpartum people have presented their stories of postdural puncture headaches on the internet, such as Kayla Peloquin, who wrote about her experience in her blog. Postdural puncture headache may be particularly disruptive for postpartum patients who are both recovering from childbirth and taking on new roles as parents. While postdural puncture headache may be a seemingly minor, resolvable complication to clinicians, to patients, these debilitating symptoms can lead to suffering and difficulty completing daily tasks and self-care. 1 This condition warrants prompt diagnosis and appropriate management to alleviate the associated symptoms and discomfort. However, experiences of positional head pains, neck stiffness, and possibly hearing symptoms within a few days of the dural puncture suggest a diagnosis of postdural puncture headache. Fortunately, most individuals who undergo dural puncture, whether intentional or accidental, do not develop postdural puncture headaches. Dural puncture can occur either as a planned procedure during routine clinical care or as an unexpected complication of neuraxial procedures.
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