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TheScientificWorldJOURNAL
Volume 9 (2009), Pages 715-722
http://dx.doi.org/10.1100/tsw.2009.94
Research Article

A 5-Year Audit of Accidental Dural Punctures, Postdural Puncture Headaches, and Failed Regional Anesthetics at a Tertiary-Care Medical Center

1Magee-Womens Hospital, Department of Anesthesiology, University of Pittsburgh School of Medicine, USA
2Duquesne University, School of Business, Pittsburgh, PA, USA

Received 12 February 2009; Revised 25 June 2009; Accepted 26 June 2009

Academic Editor: John P. Williams

Copyright © 2009 Sukhdip Singh et al.

Abstract

Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65–0.82) for ADP, 0.49% (95% CI: 0.43–0.56) for PDPH, and 0.65% (95% CI: 0.57–0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p < 0.01), epidural block (p < 0.01), and vaginal delivery (p< 0.01).