Skip to main content Accessibility help
Hostname: page-component-59b7f5684b-hd9dq Total loading time: 1.645 Render date: 2022-09-26T13:10:03.459Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Book contents

Chapter 11 - Accidental Dural Puncture

Published online by Cambridge University Press:  08 March 2019

Tauqeer Husain
Ashford and St Peter’s NHS Foundation Trust, Surrey
Roshan Fernando
Womens Wellness and Research Centre, Hamad Medical Corporation, Qatar
Scott Segal
Wake Forest University, North Carolina
Get access


Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Obstetric Anesthesiology
An Illustrated Case-Based Approach
, pp. 53 - 57
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Apfel, CC, Saxena, A, Cakmakkaya, OS, et al. Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic review. Br J Anaesth 2010; 105(3):255–63.CrossRefGoogle ScholarPubMed
Choi, PT, Galinski, SE, Takeuchi, L, et al. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Can J Anesth 2003; 50(5):460–69.CrossRefGoogle ScholarPubMed
Morely-Forster, P, Singh, S, Angle, P, et al. The effect of epidural needle type on post dural puncture headache. Can J Anesth 2006; 53(6):572–78.Google Scholar
Norris, MC, Leighton, BL, DeSimone, CA. Needle bevel direction and headache after inadvertent dural puncture. Anesthesiology 1989; 70(5):729–31.CrossRefGoogle ScholarPubMed
Richardson, MG, Wissler, RN. The effects of needle bevel orientation during epidural catheter insertion in laboring parturients. Anesth Analg 1999; 88(2):352–56.Google ScholarPubMed
Schier, R, Guerra, D, Aguilar, J, et al. Epidural space identification: a meta-analysis of complications after air versus liquid as the medium for loss of resistance. Anesth Analg 2009; 109(6):2012–21.CrossRefGoogle ScholarPubMed
Davies, RG, Laxton, CJ, Donald, FA, et al. Unrecognised dural punctures. Int J Obstet Anesth 2003; 12(2):142–43.CrossRefGoogle ScholarPubMed
Sprigge, JS, Harper, SJ. Accidental dural puncture and post dural puncture headache in obstetric anaesthesia: presentation and management. A 23-year survey in a district general hospital. Anaesthesia 2007; 63(1):3643.CrossRefGoogle Scholar
Gleeson, CM, Reynolds, F. Accidental dural puncture rates in UK obstetric practice. Int J Obstet Anesth 1998; 7:242–46.CrossRefGoogle ScholarPubMed
Hardy, PAJ. Can epidural catheters penetrate dura mater? An anatomical study. Anaesthesia 1986; 41(11):1146–47.CrossRefGoogle ScholarPubMed
Reynolds, F, Speedy, HM. The subdural space: the third place to go astray. Anaesthesia 1990; 45(2):120–23.CrossRefGoogle ScholarPubMed
Cohen, S, Casciano, M. Unrecognised dural punctures- revisited. Int J Obstet Anesth 2004; 12(13):5758.CrossRefGoogle Scholar
Pollock, JE. Neurotoxicity of intrathecal local anaesthetics and transient neurological symptoms. Best Pract Res Clin Anaesthesiol 2003; 17(3):471–84.CrossRefGoogle ScholarPubMed
Cohn, J, Moaveni, D, Sznol, J, Ranasinghe, J. Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period. Int J Obstet Anesth 2016; 25:3036.CrossRefGoogle Scholar
ValleJo, MC. Regional anaesthesia/ analgesia techniques in obstetrics, in Suresh, M, Shnider, SM, Levinson, G. (eds.), Shnider and Levinson’s Anesthesia for Obstetrics, 5th edn. Baltimore, MD: Lippincott Williams & Wilkins; 2013, pp. 119–43.Google Scholar
Al-metwalli, RR. Epidural morphine injections for prevention of post dural puncture headache. Anaesthesia 2008; 63(8):847–50.CrossRefGoogle ScholarPubMed
Ayad, S, Demian, Y, Narouze, SN, Tetzlaff, JE. Subarachnoid catheter placement after wet tap for analgesia in labor: influence on the risk of headache in obstetric patients. Reg Anesth Pain Med 2016; 28(6):512–15.Google Scholar
Cohen, S, Amar, D, Pantuck, EJ, Singer, N, Divon, M. Decreased incidence of headache after accidental dural puncture in caesarean delivery patients receiving continuous postoperative intrathecal analgesia. Acta Anaesthesiol Scand 1994; 38(7):716–18.CrossRefGoogle ScholarPubMed
Brownridge, P. The management of headache following accidental dural puncture in obstetric patients. Anaesth Intensive Care 1983; 11(1):415.CrossRefGoogle ScholarPubMed
Trivedi, NS, Eddi, D, Shevde, K. Headache prevention following accidental dural puncture in obstetric patients. J Clin Anesth 1993; 5(1):4245.CrossRefGoogle ScholarPubMed
Craft, JB, Epstein, BS, Coakley, CS. Prophylaxis of dural-puncture headache with epidural saline. Anesth Analg 1973; 52(2):228–31.CrossRefGoogle ScholarPubMed
Thompson, D, Halpern, S, Wilson, DB. Second stage pushing correlates with headache after unintentional dural puncture in parturients. Can J Anesth 1999; 46(9):861–66.Google Scholar
Ravindran, RS, Viegas, OJ, Tasch, MD, et al. Bearing down at the time of delivery and the incidence of spinal headache in parturients. Anesth Analg 1981;60(7):524–26.CrossRefGoogle ScholarPubMed
Arevalo-Rodriguez, I, Ciapponi, A, Roqué i Figuls, M, Muñoz, L, Bonfill Cosp, X. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev 2016.
Jeskins, GD, Moore, P, Cooper, GM, Lewis, M. Long-term morbidity following dural puncture in an obstetric population. Int J Obstet Anesth 2001; 10(1):1724.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats