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1

Angle, Pamela J., Jean E. Kronberg, Dorothy E. Thompson, et al. "Dural Tissue Trauma and Cerebrospinal Fluid Leak after Epidural Needle Puncture." Anesthesiology 99, no. 6 (2003): 1376–82. http://dx.doi.org/10.1097/00000542-200312000-00021.

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Background The effects of epidural needle design, angle, and bevel orientation on cerebrospinal fluid leak after puncture have not been reported. The impact of these factors on leak rate was examined using a dural sac model. Dural trauma was examined using scanning electron microscopy. Methods Human cadaveric dura, mounted on a cylindrical model, was punctured with epidural needles using a micromanipulator. Tissue was punctured at 15 cm H2O (left lateral decubitus) system pressure, and leak was measured at 25 cm H2O (semisitting) pressure. Leak rates and trauma were compared for the following:
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Vaz Antunes, Maria, Adriano Moreira, Catarina Sampaio, and Aida Faria. "Punção Acidental da Dura e Cefaleia Pós-punção da Dura na População Obstétrica: Oito Anos de Experiência." Acta Médica Portuguesa 29, no. 4 (2016): 268. http://dx.doi.org/10.20344/amp.6815.

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<p><strong>Introduction:</strong> Accidental dural puncture is an important complication of regional anesthesia and post-dural puncture headache remains a disable outcome in obstetric population. The aim of our study was to calculate the incidence of accidental puncture and post-puncture headache and evaluate its management among obstetric anesthesiologists.<br /><strong>Material and Methods:</strong> We conducted a retrospective audit, between January 2007 and December 2014. We reviewed the record sheets of patients who experienced either accidental punctur
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Macdonald, R., and G. Lyons. "Unintentional dural puncture." Anaesthesia 43, no. 8 (1988): 705. http://dx.doi.org/10.1111/j.1365-2044.1988.tb04168.x.

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Cyna, A. "Inadvertent dural puncture." BMJ 320, no. 7245 (2000): 1338. http://dx.doi.org/10.1136/bmj.320.7245.1338.

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Okell, R. W., and J. S. Sprigge. "Unintentional Dural Puncture." Obstetric Anesthesia Digest 8, no. 1 (1988): 20. http://dx.doi.org/10.1097/00132582-198804000-00023.

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Peralta, Feyce M., Cynthia A. Wong, Nicole Higgins, Paloma Toledo, Mary Jane Jones, and Robert J. McCarthy. "Prophylactic Intrathecal Morphine and Prevention of Post–Dural Puncture Headache." Anesthesiology 132, no. 5 (2020): 1045–52. http://dx.doi.org/10.1097/aln.0000000000003206.

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Abstract Background Prophylactic epidural morphine administration after unintentional dural puncture with a large-bore needle has been shown to decrease the incidence of post–dural puncture headache. The authors hypothesized that prophylactic administration of intrathecal morphine would decrease the incidence of post–dural puncture headache and/or need for epidural blood patch after unintentional dural puncture. Methods Parturients with an intrathecal catheter in situ after unintentional dural puncture with a 17-g Tuohy needle during intended epidural catheter placement for labor analgesia wer
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7

Rao, Gundala Shashidar, Yugandhar Kandula, and Kiran Kumar Suggala. "Intrathecal Catheterisation after an Accidental Dural Puncture: A measure to Decrease the Incidence of Post Dural Puncture Headache." Indian Journal of Anesthesia and Analgesia 10, no. 1 (2023): 33–34. http://dx.doi.org/10.21088/ijaa.2349.8471.10123.5.

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Accidental dural puncture is the most common major complication during epidural anaesthesia and causes high risk of post dural puncture headache (PDPH). Intrathecal catherisation in such cases helps in preventing leakage of CSF and thereby decreasing the incidence of PDPH. Here is one such case report of inadvertent intradural puncture during epidural anaesthesia.
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Lv, Ming, Chuhan Jiang, Dong Liu, Zhiguang Ning, Jun Yang, and Zhongxue Wu. "Direct percutaneous transorbital puncture under fluoroscopic guidance with a 3D skull reconstruction overlay for embolisation of intraorbital and cavernous sinus dural arteriovenous fistulas." Interventional Neuroradiology 21, no. 3 (2015): 357–61. http://dx.doi.org/10.1177/1591019915582925.

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Objective To describe the direct percutaneous transorbital puncture technique for embolisation of the selected intraorbital and cavernous sinus dural arteriovenous fistula, which failed to be treated by conventional endovascular techniques. Methods One case of intraorbital and five cases of cavernous sinus dural arteriovenous fistula were embolised through direct percutaneous transorbital puncture in 2012, and the clinical data were reviewed. Under fluoroscopic guidance with a three-dimensional (3D) skull reconstruction overlay, the cavernous sinus or ophthalmic vein was punctured via the supe
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9

Byshovets, S. M. "Post-dural puncture headache." EMERGENCY MEDICINE 19, no. 3 (2023): 120–27. http://dx.doi.org/10.22141/2224-0586.19.3.2023.1569.

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The problem was analyzed and the pathophysiology of post-dural puncture headache was highlighted. Clinical manifestations, risk factors and diagnosis of this complication are given. Modern methods for the treatment of post-dural puncture headache are described. The own experience on the prevention of this problem was made public with the conclusion that when using Ball-Pen needles, only 12 (0.56 %) of 2125 patients complained of post-dural puncture hea­dache, which is 12.5 times less than the average statistical indicators.
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10

Van de Velde, Marc. "Accidental Dural Puncture and Postdural Puncture Headache." Regional Anesthesia and Pain Medicine 41, no. 2 (2016): 121–22. http://dx.doi.org/10.1097/aap.0000000000000357.

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11

Younggren, Bradley N. "Lumbar Puncture and Post-Dural Puncture Headaches." Journal of Emergency Medicine 39, no. 5 (2010): 658–59. http://dx.doi.org/10.1016/j.jemermed.2008.12.018.

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Van de Velde, M. "Accidental Dural Puncture and Postdural Puncture Headache." Obstetric Anesthesia Digest 37, no. 1 (2017): 25–26. http://dx.doi.org/10.1097/01.aoa.0000512018.64827.95.

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Khizer, Saad, Madiha Zafar, Varda Balouch, Mubashar Iqbal, Rooshaan Kaleem, and Shahidadalat Chaudhry. "Dexamethasone in Preventing Post Dural Puncture Headache." Pakistan Journal of Medical and Health Sciences 16, no. 1 (2022): 870–73. http://dx.doi.org/10.53350/pjmhs22161870.

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Background and Aim: Post-dural puncture headache is major complication of spinal anesthesia that occurs in 40% of cases. Invasive treatment like an epidural blood patch might be required for post-dural puncture headache. The Dexamethasone effect on Post-Dural Puncture Headache following spinal anesthesia is not addressed and well understood. The aim of the present study was to assess the role of Dexamethasone in post-dural puncture headaches. Materials and Methods: This cross-sectional study was carried out on 456 patients who underwent spinal anesthesia from 16th April 2021 to 15th October 20
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14

Wrobel, Marc, and Thomas Volk. "Post-Dural Puncture Headache." Anesthesiology and Pain Medicine 1, no. 4 (2012): 273–74. http://dx.doi.org/10.5812/aapm.3610.

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Wrobel, Marc, and Thomas Volk. "Post-Dural Puncture Headache." Anesthesiology and Pain Medicine 1, no. 4 (2012): 273–74. http://dx.doi.org/10.5812/anesthpain.3610.

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16

Deo, G. "Post Dural Puncture Headache." Journal of Chitwan Medical College 3, no. 1 (2013): 5–10. http://dx.doi.org/10.3126/jcmc.v3i1.8457.

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Spinal anaesthesia developed in the late 1800s. In 1891, Wynter and Quincke aspirated cerebrospinal fluid (CSF) from the subarachnoid space for the treatment of raised intracranial pressure associated with tuberculous meningitis. However it was German surgeon, August Bier, probably first gave spinal anaesthesia and also experienced headache. He first reported this headache being related to excessive loss of cerebrospinal fluid (CSF). Recently there are lots of modification in needle size and its tip which lead to sharp decline in the incidence of post dural puncture headache (PDPH). Various co
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17

Barker, P. "Headache after dural puncture." Anaesthesia 44, no. 8 (1989): 696–97. http://dx.doi.org/10.1111/j.1365-2044.1989.tb13608.x.

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18

Sharma, R., A. Bailey, and J. Bamber. "Post-dural puncture headache." British Journal of Anaesthesia 92, no. 3 (2004): 449–50. http://dx.doi.org/10.1093/bja/aeh528.

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19

R, Prabhavathi, Chaitanya Kumar G, and Narasimha Reddy P. "POST DURAL PUNCTURE HEADACHE." Journal of Evolution of Medical and Dental Sciences 3, no. 36 (2014): 9426–34. http://dx.doi.org/10.14260/jemds/2014/3216.

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20

REYNOLDS, FELICITY. "AVOIDING ACCIDENTAL DURAL PUNCTURE." British Journal of Anaesthesia 61, no. 4 (1988): 515–16. http://dx.doi.org/10.1093/bja/61.4.515.

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21

McSwiney, M., and J. Phillips. "Post dural puncture headache." Acta Anaesthesiologica Scandinavica 39, no. 7 (1995): 990–95. http://dx.doi.org/10.1111/j.1399-6576.1995.tb04212.x.

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Bolden, Norman, and Ermias Gebre. "Accidental Dural Puncture Management." Regional Anesthesia and Pain Medicine 41, no. 2 (2016): 169–74. http://dx.doi.org/10.1097/aap.0000000000000339.

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23

Reynolds, F. "Dural puncture and headache." BMJ 306, no. 6882 (1993): 874–76. http://dx.doi.org/10.1136/bmj.306.6882.874.

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Whiteley, S. M., P. G. Murphy, R. W. Kirollos, and S. R. Swindells. "Headache after dural puncture." BMJ 306, no. 6882 (1993): 917–18. http://dx.doi.org/10.1136/bmj.306.6882.917.

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Singh, J., S. Ranjit, S. Shrestha, T. Limbu, and S. B. Marhatha. "Post dural puncture headache." Journal of Institute of Medicine Nepal 32, no. 2 (2010): 30–32. http://dx.doi.org/10.59779/jiomnepal.501.

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Introduction: Post dural puncture headache occurs as the cerebrospinal fluid leaks out from the breach that the needle has made in the dura. The incidence of Post Dural Puncture Headache (PDPH) is a common complication after spinal anesthesia. The objective of our study is to find out incidence of PDPH in patients undergoing surgery under spinal anesthesia in Dhulikhel Hospital. Methods: 120 patients who underwent spinal anesthesia were selected for the study. Questionnaire was used to assess the post dural puncture headache 24 hours after surgery. Headache, if present in frontal or occipital
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26

Richardson, Michael G., and Curtis L. Baysinger. "Dural Puncture Epidural Technique." Anesthesia & Analgesia 125, no. 2 (2017): 700. http://dx.doi.org/10.1213/ane.0000000000002221.

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Hoeffel, C. C. "Post-dural puncture headache." Radiology 203, no. 2 (1997): 579–80. http://dx.doi.org/10.1148/radiology.203.2.9114130.

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Davies, J. R. "Post dural puncture headache." Anaesthesia 58, no. 4 (2003): 398. http://dx.doi.org/10.1046/j.1365-2044.2003.03095_20.x.

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Clark, M. J., and W. F. S. Sellers. "Post dural puncture headache." Anaesthesia 58, no. 1 (2003): 101. http://dx.doi.org/10.1046/j.1365-2044.2003.296824.x.

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30

McGoldrick, Kathryn E. "Post-Dural Puncture Headache." Survey of Anesthesiology 48, no. 4 (2004): 197–98. http://dx.doi.org/10.1097/01.sa.0000132020.80384.d6.

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Bolden, Norman, and Ermias Gebre. "Accidental Dural Puncture Management." Obstetric Anesthesia Digest 37, no. 1 (2017): 25. http://dx.doi.org/10.1097/01.aoa.0000512017.26709.e4.

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Valença, Marcelo Moraes, and Raimundo Pereira Silva-Néto. "Post-dural puncture headache." Headache Medicine 14, no. 1 (2023): 1–2. http://dx.doi.org/10.48208/headachemed.2023.1.

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Rita Veloso de Sousa, Ana Belén Ortega López, and José Francisco Guillén Perales. "Hematoma subdural como complicación de analgesia epidural de parto. A propósito de dos casos." Revista Electrónica AnestesiaR 10, no. 9 (2018): 2. http://dx.doi.org/10.30445/rear.v10i9.648.

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Las hemorragias intracraneales son una complicación infrecuente pero potencialmente grave tras la punción dural asociada a anestesia neuroaxial. Las consecuencias pueden ser catastróficas, especialmente cuando hablamos de anestesia neuroaxial obstétrica en mujeres jóvenes y sanas. El diagnóstico puede ser difícil por la similitud de síntomas con la cefalea postpunción dural (CPPD), que es la complicación más frecuente tras una punción dural. Este trabajo tiene como objetivo, aumentar la conciencia de los profesionales ante la posibilidad de ocurrencia de este tipo de complicaciones ante una pu
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34

Marciniuk, K., and K. Meguro. "P.131 Acute subdural hematoma in obstetric patients following epidural anesthesia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (2022): S42. http://dx.doi.org/10.1017/cjn.2022.219.

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Background: Post-dural puncture headache is a known complication of neuraxial anesthesia and acute subdural hematoma has been associated with unintentional dural puncture. Notably, a significant number of unintentional dural punctures remain unidentified. We present two contrasting cases of subdural hematoma (SDH) following labour epidural anesthesia with no sign of dural puncture at time of anesthesia. Patient 1 presented with headache post-partum day (PPD) six, SDH was identified PPD23, and blood-patch treatment performed PPD35. Patient 2 presented with headache immediately, had SDH identifi
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Emyedu, Andrew, Bernadette Kyoheirwe, and Patience Atumanya. "Continuous Spinal Anesthesia following Inadvertent Dural Puncture during Epidural Placement for an Emergency Laparotomy." Case Reports in Anesthesiology 2021 (March 8, 2021): 1–4. http://dx.doi.org/10.1155/2021/8819864.

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Summary. Emergency exploratory laparotomy conducted under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Background and Objectives. Continuous spinal anesthesia is one of the least utilized regional anesthesia techniques globally. It could be an alternative anesthesia technique for abdominal and lower limb surgeries following an accidental dural puncture. The aim of this report was to describe a case in which continuous spinal anesthesia was successfully conducted for emergency exploratory laparotomy following an accidental dural puncture dur
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36

Aijaz Ali, Danish, Abdul Khalique, Syed Khurram Naseer, and Amir Suhail. "Frequency of Post Dural Puncture Headache with Median Versus Para-Median Approach of Spinal Anaesthesia in Patients Underwent Cesarean Section." Pakistan Armed Forces Medical Journal 73, SUPPL-1 (2023): S132–135. http://dx.doi.org/10.51253/pafmj.v73isuppl-1.3077.

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Objective: To compare the frequency of post dural puncture headache with median versus para-median approach of spinal anaesthesia in females undergoing cesarean section. Study Design: Comparative cross-sectional study. Place and Duration of Study: Anesthesiology and Obstetric departments, Combined Military Hospital, Badin Pakistan, from Oct 2018 to Apr 2019. Methodology: Total 128 females undergoing cesarean section, fulfilling the inclusion criteria were included randomly in two equal groups. Group-A received spinal anaesthesia with 25 G Quincke spinal needle by median approach while Group-B
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Shrestha, Babu Raja, Shyam Krishna Maharjan, Ujma Shrestha, and Sushila Lama Moktan. "Epidural blood patch in post-dural puncture headache in parturients: A case series." Journal of Kathmandu Medical College 9, no. 3 (2020): 169–72. http://dx.doi.org/10.3126/jkmc.v9i3.36416.

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This is a case series of six obstetric patients who had post-dural puncture headache, resistant to conservative treatment. The onset of post-dural headache in our series on average was on the 34th hour of the procedure. After confirmation of the diagnosis with a typical history of presentation and examination, the patients underwent pharmacological treatment. Post-dural puncture headache, in our series, not relieved by pharmacological treatment underwent epidural blood patch after persistent headache in an average of 5 days post-dural puncture. All patients receiving this therapy had a complet
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Kuczkowski, K. M., and J. L. Benumof. "ONCE A POST-DURAL PUNCTURE HEADACHE PATIENT, ALWAYS POST-DURAL PUNCTURE HEADACHE PATIENT." Anesthesiology 96, no. 4 (2002): NA. http://dx.doi.org/10.1097/00000542-200204001-00042.

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Gobin, J., L. Lonjaret, A. Pailhas, F. Bayoumeu, and V. Minville. "Accidental dural puncture: Combination of prophylactic methods to avoid post-dural puncture headache." Annales Françaises d'Anesthésie et de Réanimation 33, no. 5 (2014): e95-e97. http://dx.doi.org/10.1016/j.annfar.2014.03.019.

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Safa-Tisseront, Valérie, Françoise Thormann, Patrick Malassiné, et al. "Effectiveness of Epidural Blood Patch in the Management of Post–Dural Puncture Headache." Anesthesiology 95, no. 2 (2001): 334–39. http://dx.doi.org/10.1097/00000542-200108000-00012.

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Background Lumbar epidural blood patch (EBP) is a common treatment of post-dural puncture headache, but its effectiveness and mode of action remain a matter of debate. The aim of this study was to assess both the effectiveness and the predictive factors of failure of EBP on severe post-dural puncture headache. Methods This prospective observational study includes all patients treated in the authors' hospital with EBP for incapacitating post-dural puncture headache, from 1988 to 2000. The EBP effect was classified into complete relief (disappearance of all symptoms), incomplete relief of sympto
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Schievink, Wouter I., M. Marcel Maya, and Franklin G. Moser. "Digital subtraction myelography in the investigation of post–dural puncture headache in 27 patients: technical note." Journal of Neurosurgery: Spine 26, no. 6 (2017): 760–64. http://dx.doi.org/10.3171/2016.11.spine16968.

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OBJECTIVEPost–dural puncture headaches are common, and the treatment of such headaches can be complex when they become chronic. Among patients with spontaneous spinal CSF leaks, digital subtraction myelography (DSM) can localize the exact site of the leak when an extradural CSF collection is present, and it can also demonstrate CSF-venous fistulas in those without an extradural CSF collection. The authors now report on the use of DSM in the management of patients with chronic post–dural puncture headaches.METHODSThe patient population consisted of a consecutive group of 27 patients with recalc
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Bohara, Chetan, Rajesh Maharjan, Subi Regmi, Gunjan Regmi, Rajendra Kunwar, and Anup Shrestha. "A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia." Med Phoenix 6, no. 1 (2021): 28–31. http://dx.doi.org/10.3126/medphoenix.v6i1.36732.

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Introduction: Spinal anesthesia has offered a new armamentarium for the anesthesiologists and has been widely used in the Cesarean section in the field of obstetrics, an alternative to general anesthesia. However, Post Dural Puncture Headache remains an inevitable complication of spinal anesthesia and can be minimized its incidence by reducing the size of the needle and changing the design of the needle tip. The objective of the study was to find the incidence of post-dural puncture headache undergoing subarachnoid block for CS using 25G Quincke and 25G Whitacre needles.
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Baysinger, Curtis L. "Accidental Dural Puncture and Postdural Puncture Headache Management." International Anesthesiology Clinics 52, no. 3 (2014): 18–39. http://dx.doi.org/10.1097/aia.0000000000000021.

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Nkadam, Monday Nwizor, Sunday Imasuen, and Rex Friday Ogoronte Alderton Ijah. "Management of Inadvertent Dural Puncture Following Thoracic Epidural anesthesia for Mastectomy: A Case Report." International Journal of TROPICAL DISEASE & Health 45, no. 6 (2024): 127–32. http://dx.doi.org/10.9734/ijtdh/2024/v45i61545.

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Background: Thoracic Epidural has been successfully used to administer anesthesia for mastectomy. However inadvertent dural puncture is a major complication occurring in about 0.19 to 3.6% during epidural anesthesia, even in very experienced hands with need for immediate and proper management. We present a case of mastectomy done under thoracic epidural anesthesia following inadvertent dural puncture, using same interspace. Case Presentation: A 62-year-old known hypertensive female patient with good drug compliance, weighing 68kg and 1.68m in height with stage IV right breast cancer. She under
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45

Das, Arunima, Rahaman Mijanur Shaikh, and Manabendra Sarkar. "A Prospective Comparative Study between Dural Puncture Epidural and Lumbar Epidural in Knee and Hip Arthroplasty." International Journal of Toxicological and Pharmacological Research 13, no. 9 (2023): 39–49. https://doi.org/10.5281/zenodo.11079198.

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<strong>General Objective:&nbsp;</strong>To compare the effectiveness of Dural puncture epidural with Lumbar epidural techniques regarding onset, duration and regression of analgesia in knee and hip arthroplasty.&nbsp;<strong>Specific Objective:&nbsp;</strong>(1) To compare onset of sensory (T8 level) and motor block between Dural puncture epidural and Lumbar epidural group in knee and hip arthroplasty. (2) To compare duration of analgesia between dural puncture epidural and lumbar epidural group in knee and hip arthroplasty. (3) To find out hemodynamic variables (arrhythmia, hypotension, palp
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Abdi, Nisrina Nabilah, Dody Firmanda, Abdul Harris Pane, and Aulia Novasyra. "GAMBARAN KEJADIAN POST DURAL PUNCTURE HEADACHE (PDPH) PADA PASIEN SECTIO CAESAREA DENGAN ANESTESI SPINAL DI RSU HAJI MEDAN." Jurnal Kedokteran STM (Sains dan Teknologi Medik) 8, no. 2 (2025): 156–64. https://doi.org/10.30743/stm.v8i2.841.

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Background: Post-Dural Puncture Headache (PDPH) is a complication that can occur after spinal anesthesia, typically characterized by a headache in the frontal or occipital regions, which is position-dependent, worsening when the patient stands and improving when the patient lies down. Objective: To determine the frequency distribution of post-dural puncture headache (PDPH) cases in patients undergoing cesarean section with spinal anesthesia at Haji General Hospital Medan. Methods : This study used a descriptive observational design with purposive sampling technique. A total of 36 samples were
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Hakizimana, Theoneste, Osman Mohamud Jelle, and Marie Pascaline Sabine Ishimwe. "Prevalence, common clinical presentations and severity patterns of post-dural puncture headache among parturients who underwent cesarean section using spinal anesthesia in western Uganda: a cross-sectional study." International Journal of Scientific Reports 10, no. 1 (2023): 1–6. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20233865.

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Background: Post-dural puncture headache is a complication of regional blocks that results from intentional dural puncture during spinal anesthesia and unintentional dural puncture during epidural anesthesia. The aim of the study was to determine the prevalence, common clinical presentations and severity of post-spinal puncture headache among parturients who underwent cesarean section using spinal anesthesia in western Uganda. Methods: A cross-sectional study was conducted on 249 mothers who were consecutively enrolled in their 3rd post-partum day during the period from April 2022 to July 2022
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Wu, Christopher L., Andrew J. Rowlingson, Seth R. Cohen, et al. "Gender and Post–Dural Puncture Headache." Anesthesiology 105, no. 3 (2006): 613–18. http://dx.doi.org/10.1097/00000542-200609000-00027.

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Gender is believed to be an independent risk factor for the development of post-dural puncture headache, but there are some of the inconsistencies in the available data. This systematic review examined a total of 18 trials (2,163 males, 1,917 females). The odds of developing a post-dural puncture headache were significantly lower for male than nonpregnant female subjects (odds ratio = 0.55; 95% confidence interval, 0.44-0.67). Although the authors found that nonpregnant female subjects seem to have a higher incidence of post-dural puncture headache than males, the etiology behind these finding
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Thummala, Vengamamba, Lella Nageswararao, Devireddy Swetha, Siddabsttula Sriharitha, and U. Mounica. "Accidental dural puncture-perioperative management." Indian Journal of Anaesthesia 64, no. 5 (2020): 425. http://dx.doi.org/10.4103/ija.ija_328_19.

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Levy, D. M. "Postpartum post-dural puncture headache." British Journal of Anaesthesia 94, no. 4 (2005): 542–43. http://dx.doi.org/10.1093/bja/aei523.

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