Epidural Filling with Crystal-colloid Solution for Post Accidental Dural Puncture Headache: A Case Series.

Purpose: Post dural puncture headache (PDPH) is a common anesthetic complication caused by expected spinal puncture or accidental dural puncture during intraspinal anesthesia operation. The purpose of this study was to retrospectively analyze the clinical features and outcomes of parturients with accidental dural punctures (ADP).

Methods: (All cesarean sections at the Chongqing Health Center for Women and Children (Chongqing, China) carried out under neuraxial anesthesia from January 1, 2017 to December 31, 2018 were reviewed and data from 20 parturients with ADP were collected and analyzed.

Results: Seventeen individuals received crystal-colloid solution fillers and three did not. The median epidural catheter retaining time was 40 hours; the median frequency of epidural filling was three times, with a median total volume of 60 ml. One patient developed tinnitus and three complained of head swelling during filling. The median bed-stay duration was 73 hours, with total intravenous infusion volume of 7.3 L in the first three postoperative days. Two patients complained of slight dizziness and mitigation, and five felt weak. One individual had intermittent headaches and dizziness till the seventh postoperative day.

Conclusions: Epidural injection of crystal-colloid solution, combined with hydration, maybe a useful preven-tive strategy for ADP-induced headache after cesarean section.