Post-dural puncture headache as a complication of spinal anesthesia

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Abstract

Post-dural puncture headache (PDPH) is a pathological condition that occurs as a complication of spinal and epidural anesthesia. The main manifestations of this condition are headache when patients are verticalized, hemodynamic disturbances, respiratory distress, and neurological manifestations. Treatment of this condition requires a comprehensive approach, using conservative and in extreme cases invasive methods. The research purpose is to study the factors and processes leading to the development of PDPH, analyze the pattern of clinical symptoms, and evaluate possible methods for the prevention and treatment of this pathological condition. Materials and methods. The study analyzed scientific publications using the keywords “anesthesiology”, “spinal anesthesia”, “neurological complications”, “pain”, and “post-dural puncture headache treatment” for the period from 2000 to 2023. For this purpose, the online resources eLibrary and PubMed with articles published over the past 15 years were used. Results. In the pathogenesis of PDPH, the main factor is cerebrospinal fluid leakage, which is the trigger for headache. PDPH is a serious but often manageable complication following dural puncture. Conclusion. A comprehensive approach to the diagnosis and treatment of PDPH will help improve the quality of life of patients who have undergone dural puncture as quickly as possible, typically by spinal anesthesia in most cases and, less commonly, epidural anesthesia (in cases of unintentional dural puncture). This approach also helps prevent this complication.

About the authors

Alexander P. Marchenko

Derzhavin Tambov State University; Kotovsk City Clinical Hospital

Author for correspondence.
Email: sashamarchen@mail.ru
ORCID iD: 0000-0002-9387-3374

Candidate of Medicine, Associate Professor of Hospital Surgery with a Course in Traumatology of Institute of Medicine and Health Protection; Head of Anesthesiology and Resuscitation Department

33 Internatsionalnaya St., Tambov 392000, Russian Federation; 24 Pionerskaya St., Kotovsk 393190, Tambov Region, Russian Federation

Kseniya A. Pavlova

Derzhavin Tambov State University; Kotovsk City Clinical Hospital

Email: travma68@mail.ru
ORCID iD: 0000-0003-1931-0706

Assistant of Department of Hospital Surgery with a Course in Traumatology, Institute of Medicine and Health Protection; Physician of Anesthesiology and Resuscitation Department

33 Internatsionalnaya St., Tambov 392000, Russian Federation; 24 Pionerskaya St., Kotovsk 393190, Tambov Region, Russian Federation

Petr A. Ratiev

Derzhavin Tambov State University

Email: ratiev.p@mail.ru
ORCID iD: 0009-0004-6015-8632

Senior Lecturer of Hospital Surgery with a Course in Traumatology Department of Institute of Medicine and Health Protection

33 Internatsionalnaya St., Tambov 392000, Russian Federation

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