AnaesthesiaObstetricsPain Management

046 – Managing a patient with a postdural puncture headache PDPH with Dr Matt Rucklidge

Scenario:

You are called by a midwife to review a patient on the ward who had a vaginal delivery yesterday with an epidural for pain relief and now she has a bad headache. They are concerned that maybe she has a postdural puncture headache.

Join Matt and Roger again as this week they discuss the management of a patient with possible or proven post-dural puncture headache.

Links

“What I wish I knew about post-dural puncture headaches before I got an epidural” Todays Parent

Postpartum headache: diagnosis and management BJA Education 2011 Free article

2 thoughts on “046 – Managing a patient with a postdural puncture headache PDPH with Dr Matt Rucklidge

  1. Thanks everyone involved in the podcast of an interesting topic (PDPH).
    Dr Rucklidge mentioned giving a” bear hug” to the mother as a bedside test to rule out a PDPH in borderline cases which I used to practice in the past. However in the current litigious climate I avoid this manoeuvre and instead I ask the patient to perform a Valsalva manoeuvre which appears to be as reliable as the hugging the patient !

    1. Thanks for that great tip, I agree with your sentiments and admit that I have actually never done this manœuvre although I have seen colleagues do it. I will definitely try a valsalva in the future !

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