Post-dural-puncture headache

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Post-dural-puncture headache (PDPH) is a potential complication of neuraxial anesthesia techniques.

Risk Factors

The incidence of developing PDPH following accidental dural puncture is affected by several patient variables:

  • Age - those < 40 years old are more susceptible
  • Gender - females are more susceptible than males
  • Weight - morbid obesity appears to decrease the incidence
  • Pregnancy - increases incidence
  • Prior history (of PDPH) - increases incidence

Additionally, incidence decreases with higher needle gauge, increased provider experience, and use of saline (rather than air) for loss of resistance during neuraxial anesthesia techniques.