Their headache, our headache : improving the quality of care for women with post dural puncture headaches

One of the biggest success stories of over 50 years of national maternal audits (Confidential Enquiry into Maternal Deaths) is the significant reduction in anaesthetic related mortality in the UK. This has been largely attributed to the increased adoption of regional (central neuraxial) blocks in obstetric anaesthetic practice as a standard of care, in preference to general anaesthesia. However, the use of regional blockade is not without risks and one of the most noteworthy risks is post dural puncture headache (PDPH). In 2009 a national audit (NAP3) showed the expected incidence of PDPH to be 1 in 200 following a spinal block and 1 in 100 following an epidural block. Given that a large proportion of the maternal population are likely to need a central neuraxial block of some sort either for analgesia or anaesthesia during their labour, PDPH is a significant complication in labouring women.