A 5-year audit of accidental dural punctures, postdural puncture headaches, and failed regional anesthetics at a tertiary-care medical center

DOI

10.1100/tsw.2009.94

Document Type

Journal Article

Publication Date

8-1-2009

Publication Title

TheScientificWorldJournal

Volume

9

First Page

715

Last Page

722

Keywords

Accidental dural puncture, Failed regional, Maternal outcome, Postdural puncture headache

Abstract

Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65-0.82) for ADP, 0.49% (95% CI: 0.43-0.56) for PDPH, and 0.65% (95% CI: 0.57-0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p < 0.01), epidural block (p < 0.01), and vaginal delivery (p < 0.01). ©2009 with author. Published by TheScientificWorld.

Open Access

Gold

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