Management of postdural puncture headache by epidural saline delivered with a patient-controlled pump--a case report.

ABSTRACT

Unintentional dural puncture is the most frequent cause of postdural puncture headache (PDPH) in epidural anesthesia and analgesia. Conservative treatments of PDPH include bed rest, oral analgesics, and hydration. When conservative measures fail, epidural blood patch is an effective substitute. However, epidural blood patch carries some risks, such as subdural hematoma, pneumocephalus, exacerbation of PDPH and new dural puncture. Many patients may refuse the procedure due to the risks involved. We describe a female patient who had her PDPH successfully treated with epidural saline delivered by a patient-controlled analgesia device (Abbott Pain Management-APM) without molestation of her daily activities.