Chronic pain in parturients with an accidental dural puncture: A case-controlled prospective observational study

Yair Binyamin, Philip Heesen, Sharon Orbach-Zinger, Yaacov Gozal, David Halimi, Amit Frenkel, Alexander Ioscovich

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We set out to examine incidence of chronic headache and back pain in women with PDPH after accidental dural puncture during labor. Methods: Chronic headache, backache, and disability were assessed 18-24 months postpartum. Women with PDPH treated with epidural blood patch (PDPH-EBP) were identified and matched with women who had a PDPH without epidural blood patch (PDPH-no EBP), with women with uncomplicated epidural analgesia and with women without epidural analgesia. Our primary outcome was incidence of chronic headache and backache. Secondary outcome was the effect of epidural blood patch on chronic pain development. We used Chi-square or Fisher's exact test to calculate odds ratios. Results: There was no statistically significant difference in demographic characteristics between groups. In the no epidural group, no women reported chronic headache and 2/116 (1.7%) reported chronic backache. In the uncomplicated epidural group, no women reported chronic headache and 7/116 (6.0%) reported chronic backache. In the PDPH-no EBP group, 9/56 (16.1%) women reported chronic headache and 10/56 (17.9%) reported chronic backache. In the PDPH-EBP group, 12/59 (20.3%) had chronic headache and 14/59 (23.7%) had chronic backache. No women in the no epidural or uncomplicated epidural group reported disability (chronic pain score of 3 or 4). High disability was reported by 8.9% of women in the PDPH-no EBP group and by 8.4% in the PDPH-EBP group. Conclusion: Women with PDPH had a high incidence of chronic headache, back pain, and disability. We did not find a statistically significant difference in chronic pain development between conservatively treated and EBP-treated patients.

Original languageEnglish
Pages (from-to)959-966
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume65
Issue number7
DOIs
StatePublished - Aug 2021
Externally publishedYes

Keywords

  • accidental dural puncture
  • chronic backache
  • chronic headache
  • disability
  • epidural analgesia
  • post-dural puncture headache

Fingerprint

Dive into the research topics of 'Chronic pain in parturients with an accidental dural puncture: A case-controlled prospective observational study'. Together they form a unique fingerprint.

Cite this