Post Dural Puncture Headache (PDPH) – Evidence, Risks & Management | Dr. Balaji Asegaonkar

Post dural puncture headache (PDPH), though less frequent today, remains one of the most distressing complications following spinal or epidural anaesthesia. Severe cases often require targeted interventions such as an epidural blood patch.

In the 161st consecutive academic meeting of the Ozone Anaesthesia Group, Dr. Balaji Asegaonkar shared his clinical experience and evidence-based strategies to manage PDPH effectively.

🔑Key Takeaways from the Talk

🌟Case discussion: Successful management of PDPH with two epidural blood patches
🌟Why PDPH incidence remains high in pregnant patients
🌟Risk factors: female gender, thin build, previous PDPH/headache history (lower incidence in obese and smokers)
🌟Myth-busting: Bed rest & excess IV fluids don’t help; hydration should be maintained, not overloaded
🌟Current best practices: Early ambulation, analgesics, epidural blood patch in severe cases
🌟Epidural Blood Patch tips: 20 ml is optimal; can be repeated in rare cases

🌟Prevention strategies:
🌟Use small bore spinal needles
✅Minimise multiple punctures
✅Insert bevel parallel to dural fibres
✅ Reinsert stylet while removing the spinal needle

💡 This talk is a must-watch for all anaesthesiologists, residents, and obstetric anaesthesia practitioners looking to update their PDPH management.

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Credits
Video Editing- Vipul Tribhuwan/Dr. Sujitkumar Khade
Concept & Thumbnail - Dr. Sujitkumar Khade
Production- Ozone Anaesthesia Group