Review of the Alternatives to Epidural Blood Patch for Treatment of Postdural Puncture Headache in the Parturient

Abstract

Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections. Last, the evidence behind interventional pain modalities and acupuncture will be examined.