[Dural taps in peridural analgesia for labor: management by French anesthesiologists in 1997]

Ann Fr Anesth Reanim. 1999 Nov;18(9):941-8. doi: 10.1016/s0750-7658(00)87943-5.
[Article in French]


Objectives: To assess prophylactic and curative managements of dural taps occurring during the setting of epidural analgesia (EA) for labour.

Study design: Nationwide French retrospective survey.

Patients and methods: From April to July 1997, a questionnaire was sent to 799 French obstetrical units located in both teaching and non-teaching public hospitals and private institutions.

Results: Answers were obtained from 267 units (response rate of 33%). Although management of dural taps was similar in 52% of the institutions, only 8% had produced a written protocol. After a dural puncture, EA was still performed in 95% of the units, but usually in another interspace (87%). Large oral fluid intake was the most frequent prophylactic measure (81%). To prevent postdural puncture headache (PDPH), bed rest was largely used (76%) and lasted 24 hours in 46% of the institutions. Prophylactic epidural blood patch (EBP) was performed in 14% of the units. To treat PDPH, a majority of anaesthesiologists performed an EBP (92%) and most of them after a delay of 48 hours (62%). Intravenous and oral caffeine was used in 31 and 24% of the units respectively. Prior to EBP, coagulation status was assessed in about 20% of the units and blood culture in less than 3%. In 65% of the units the injection of EBP was discontinued when the patients felt backache. A large range of volumes were injected, but usually less than 20 mL were administered (81%). In 60% of the units the patients were discharged home after an overnight stay in the hospital. If the first EBP failed, a second one was performed in 61% of the cases.

Conclusion: Management of dural taps occurring after EA for pain relief in labour differs widely from one French obstetrical unit to another.

Publication types

  • English Abstract

MeSH terms

  • Anesthesia, Epidural / adverse effects*
  • Anesthesia, Obstetrical / adverse effects*
  • Data Collection
  • Dura Mater / injuries*
  • Female
  • France
  • Humans
  • Pregnancy
  • Retrospective Studies
  • Wounds and Injuries / prevention & control
  • Wounds and Injuries / therapy