Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Postdural puncture headache
from Chief complaints and diagnoses
Published online by Cambridge University Press: 18 December 2009
Edited by
Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Summary
This chapter discusses the role of caffeine, Gabapentin, and Epidural blood patch in postdural puncture headache. Postdural puncture headache (PDPH) complicates up to 5% of spinal taps and is also frequently seen postpartum (from anesthesia-related dural puncture). The best treatment for PDPH is prevention. Although a variety of approaches to PDPH have been mentioned in reviews, the drug therapy with the most supporting evidence is caffeine. Oral formulations of caffeine (300 mg per dose) are more effective than placebo for PDPH. Thrice-daily gabapentin is reported in case series to have efficacy in PDPH. The evidence is preliminary, but administration of this anticonvulsant is of potential utility when caffeine fails or is not an option, and patients are not candidates for (or refuse) epidural blood patch. The responsibility of the acute care provider to the patient with PDPH is often administration of temporizing pharmacotherapy pending availability of an epidural blood patch.
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- Chapter
- Information
- Emergency Department AnalgesiaAn Evidence-Based Guide, pp. 351 - 353Publisher: Cambridge University PressPrint publication year: 2008