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Type: Journal article
Title: Immediate management of inadvertent dural puncture during insertion of a labour epidural: a survey of Australian obstetric anaesthetists
Author: Newman, M.
Cyna, A.
Citation: Anaesthesia and Intensive Care, 2008; 36(1):96-101
Publisher: Australian Soc Anaesthetists
Issue Date: 2008
ISSN: 0310-057X
Statement of
Newman, M J and Cyna, A M
Abstract: Immediate management of inadvertent dural puncture during insertion of an epidural needle during labour is controversial and evidence to guide clinical practice is limited. We surveyed Australian obstetric anaesthetists by anonymous postal questionnaire. Of the 671 surveys sent, 417 (62%) were returned. Following dural puncture, 265 respondents (64%) indicated that they "would usually remove the Tuohy needle and resite" The most common reason for this decision was concern regarding the safety of intrathecal catheters (ITC) (n=236, 89%), in particular, the risk of misuse (n=182, 70%). The most frequently reported reason for "usually inserting an ITC" was that this reduced the incidence (n=120, 84%) and severity (n=110, 77%) of post dural puncture headache. Increased frequency of ITC insertion was reported by respondents who practised more frequent sessions of obstetric anaesthesia, had fewer years of experience as a consultant anaesthetist and worked in a public hospital. The more widespread use of ITCs seems to be limited by safety concerns.
Keywords: survey; obstetric anaesthesia; dural puncture; intrathecal catheter; epidural analgesia; post dural puncture headache
Description: © 2008 CBS Interactive Inc. All rights reserved.
RMID: 0020080213
DOI: 10.1177/0310057X0803600117
Appears in Collections:Obstetrics and Gynaecology publications

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