oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The effect of Epidural Blood Patch on Auditory Function following Accidental Dural Puncture in the Parturient: a prospective cohort study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Karolinska University Hospital, Stockholm, Sweden.
Department of Anaesthesia and Intensive Care, Capio St Görans Hospital, Stockholm.
Karolinska University Hospital, Stockholm, Sweden.
Faculty of Medicine and Health, Örebro university, Örebro, Sweden. (Clinical Epidemiology and Biostatistics)
Show others and affiliations
(English)Manuscript (preprint) (Other academic)
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-49015OAI: oai:DiVA.org:oru-49015DiVA, id: diva2:909524
Available from: 2016-03-07 Created: 2016-03-07 Last updated: 2018-09-18Bibliographically approved
In thesis
1. Post-Dural Puncture Headache in Obstetrics: Audiological, Clinical and Epidemiological studies
Open this publication in new window or tab >>Post-Dural Puncture Headache in Obstetrics: Audiological, Clinical and Epidemiological studies
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Post-dural puncture headache (PDPH) is the most common complication of obstetric epidural analgesia. The characteristic positional headache, often associated with visual, vestibular or cochlear symptoms, is severe and disabling for the parturient. The diagnosis is clinical without the possibility of confirmatory objective tests. Although epidural blood patch (EBP) is considered the gold standard for treatment of PDPH, many aspects of this treatment modality remain to be explored. This thesis was performed in order to improve our current knowledge of the diagnosis and the short and long-term consequences of PDPH. We found that the incidence of accidental dural puncture in labour epidural analgesia was 1% in the Nordic countries and 90% of these patients were managed with an EBP (study I). Auditory impairment related to PDPH was prospectively investigated in 21 parturients with PDPH treated with EBP (study II). A significantly greater number of parturients suffering from PDPH had hearing loss (> 20 dB) in the low frequency range compared to controls which improved spontaneously but independent of treatment with EBP. At 4 hours, 95% of subjects had a successful EBP but headache recurred in 24% at 24 hours. In study III, we investigated residual hearing deficit several years after PDPH treated with EBP. We found statistically significant long-term impairment of hearing but this was of minor clinical relevance. In study IV, 60 women with previous PDPH and treated with EBP responded to a validated questionnaire to determine the long-term effects of EBP on headache and backache. We found that subjects who had been treated with EBP had a significantly greater incidence and severity of headache compared to controls. The incidence of mild backache was also significantly higher but of limited clinical importance. In conclusion, PDPH after labour epidural analgesia is an important clinical problem. Parturients suffering from PDPH may have audiometric deterioration in the early postpartum period that recovers spontaneously over time and some long-term effects of PDPH on hearing may be evident but these are of minor clinical relevance. Clinically important headache, but not backache, may be present several years after PDPH.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016. p. 80
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 135
Keywords
Accidental dural puncture, post-dural puncture headache, epidural blood patch, obstetrics
National Category
Anesthesiology and Intensive Care Surgery
Research subject
Anaesthesiology; Surgery
Identifiers
urn:nbn:se:oru:diva-47475 (URN)978-91-7529-124-6 (ISBN)
Public defence
2016-04-08, Universitetssjukhuset, Wilandersalen, Södra Grev Rosengatan, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2018-04-20Bibliographically approved

Open Access in DiVA

No full text in DiVA

Authority records BETA

Darvish, BijanMöller, Claes

Search in DiVA

By author/editor
Darvish, BijanMöller, Claes
By organisation
School of Health and Medical Sciences, Örebro University, Sweden
Surgery

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 439 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf