TY - CHAP M1 - Book, Section TI - Postdural Puncture Headache A1 - Epstein, Jonathan A1 - Geier, Jacquiline A2 - Santos, Alan C. A2 - Epstein, Jonathan N. A2 - Chaudhuri, Kallol Y1 - 2015 N1 - T2 - Obstetric Anesthesia AB - Postdural puncture headache (PDPH) continues to be one of the most common complications of neuraxial anesthesia used in obstetrics. It is critical that the obstetric anesthesiologist be able to recognize the difference between PDPH, the incidence of which may approach 40%, and other causes of postpartum headache.1 PDPH is also the third most common cause of litigation stemming from neuraxial anesthesia.2 In fact, claims related to maternal death and newborn death/brain damage have steadily decreased since 1990, but PDPH settlements have seen a steady increase.3 Retrospective analysis indicates that the most frequently cited reason for a patient’s deciding to pursue legal action was a lack of full disclosure regarding potential for PDPH and/or lack of follow-up by the anesthesiologist.2 Although the headache itself is the usual official complaint, it seems that poor communication and an absence of empathy is what actually drives the majority of these legal actions. Accordingly, patients should be counseled about the risks of PDPH prior to every neuraxial anesthetic. If a Tuohy needle accidentally punctures the dura, it is imperative that, after the patient is comfortable, the potential risk of headache be once again explained. At that time, the patient should be advised of specific treatment options and reassured that adequate follow-up will be available. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1108523279 ER -