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Revista de la Sociedad Española del Dolor
Print version ISSN 1134-8046
Abstract
PERDOMO PERDOMO, M B et al. Clinical experience with the implementation of a postdural puncture headache multidisciplinary protocol. Rev. Soc. Esp. Dolor [online]. 2020, vol.27, n.2, pp.133-137. Epub May 25, 2020. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2020.3782/2019.
Introduction:
Postdural puncture headache (PDPH) is a lumbar puncture complication, this practice is used by several medical specialists for different purposes as well as the accidental dural puncture (ADP) in an epidural technique.
The objective of a PDPH multidisciplinary management protocol, is to diagnose and early treat any patient with PDPH, no matter which speciality observes this complication.
Material and methods:
A descriptive, observational and retrospective study in which the clinical helpfulness of a PDPH management protocol is analyzed between September 2014 and December 2017.
Results:
A total of 60 consult visits were analyzed. An incidence of ADP of 0.61 % was observed, 80 % of them developed PDPH, and out of these, 72 % required an epidural blood patching. Re-entry due to clinical worsening was required by 8 patients on telephone follow-up, who were initially discharged with mild PDPH, and one of them was diagnosed with abducens nerve palsy. Medical specialities with patients in this protocol were: anesthesiologists, obstetricians, emergency physicians and neurologists.
Conclusions:
The protocol allowed a diagnosis and early treatment of the PDPH as well as supplied the patient's follow-up after his hospital discharge.
Keywords : Postdural puncture headache; epidural blood patch; protocol; accidental dural puncture; lumbar puncture.