Postdural Puncture Headaches and the Development of a Treatment Protocol

Author

Matthew GillFollow

Date of Award

Spring 5-2023

Document Type

DNP Project

Project Team Faculty Member

Matthew Bednarchik

Project Team Faculty Member

Beth McCoy

Keywords

postdural puncture headache, PDPH, post-dural puncture headache, post dural puncture headache, obstetric complications

Abstract

Roughly 1% of patients receiving an epidural for analgesia will experience an accidental dural puncture (ADP). Of that 1%, half will go on to develop a postdural puncture headache (PDPH) (Apfel, 2010). PDPH presents 24-48 hours after neuraxial anesthesia as a dull, bilateral, throbbing, postural headache that is often accompanied by nausea (Patel et al., 2020). Although PDPH is a fairly common complication associated with neuraxial anesthesia, many facilities offering obstetric services lack a written protocol addressing ADP and PDPH treatment. The purpose of this project was to design and introduce a PDPH evidence-based treatment protocol for a hospital in the St. Louis metro-east region to combat the impact PDPH has on maternal-newborn bonding, patient satisfaction, and length of hospitalization. Through a comprehensive review of the literature, the most recent evidence of PDPH risk factors, prevention strategies, and treatment options were discovered and compiled into an educational presentation for the host facility anesthesia staff. This project utilized a non-experimental design and aimed at quality improvement. A pre and post educational presentation questionnaire were anonymously and voluntarily completed by staff in attendance to gauge the effectiveness of the educational presentation. Overall, questionnaire scores improved following the educational presentation. Anesthesia staff reported that they planned to adopt the proposed treatment protocol into their daily practice.

Recommended Citation

Gill, Matthew, "Postdural Puncture Headaches and the Development of a Treatment Protocol" (2023). Doctor of Nursing Practice Projects. 283.
https://spark.siue.edu/dnpprojects/283

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