POSTDURAL PUNCTURE HEADACHE

In the given work the review of literature about one of complications of spinal and epidural anesthesia's – postdural puncture headache – is given. The importance of this problem consists in the rate of its occurrence, and besides, in many cases the headache is not considered a complication requiring attention. According to different data, headache is noted in 1-5% of patients after epidural anesthesia, and in 40% of patients after spinal anesthesia. Most commonly this syndrome is seen in individuals at the age from 15 to 50. It is accepted to divide risk factors for development of postdural puncture headache to: factors associated with patient; factors associated with a used puncture needle, and associated with competence of a specialist making puncture. Pain emerging after spinal and epidural anesthesia has been studied for rather a long time, and at present the pathogenesis of postdural puncture headache is sufficiently clear. It is based on dilation of the intracranial vessels and descent of the brain with tension of the intracranial structures. The diagnosis of postdural puncture pain rests on the clinical manifestations of this syndrome, the leading ones being headache or backache. However, there exist certain disagreements concerning methods of prophylaxis and choice of the effective treatment. Postdural puncture syndrome creates considerable discomfort to patients, limiting their freedom of movements and other physical activity because of excruciating headache. Unintentional puncture of the dura mater during epidural anesthesia used for labor pain relief, and emergence of postdural puncture syndrome may limit childcare activity of mothers.