DURAL PUNCTURE - THE PATIENTS PERSPECTIVE - A PATIENT SURVEY OF CASESAT A DGH-MATERNITY-UNIT, 1983-1993

Background: This study was designed to investigate the patient experie nce following accidental dual puncture complicating obstetric epidural analgesia. Methods: Sixty-three patients who had suffered from accide ntal dual puncture during obstetric epidural analgesia over a ten-year period were sent a questionnaire enquiring about their experiences. 6 8% responded. Results: Headache was the most severe symptom, occurring in 86% of this group; it lasted for a median of eight days and recurr ed after discharge in 47%. Backache occurred in 70% and 58% suffered w ith backache following discharge. Headache was considered to be the wo rst aspect by 49% of responders, backache by 19% and bedrest by 33%. B ed rest was frequently voluntary (as opposed to being enforced on medi cal orders) since many patients only gained relief from their headache when supine. Twenty patients (47%) received a blood patch, which was effective in relieving headache in 14 patients; however, the headache recurred after discharge in 10 of these 14 patients. Only 8 patients ( 19%) stated that they were aware of the risk of dual puncture prior to their epidural, three of whom were members of paramedical professions . Conclusions: Headache and backache are both common following dural p uncture with a 16G needle and both frequently recur after discharge fr om hospital. It was the strongly expressed opinion of this selected gr oup that all mothers should be warned of the risk of dural puncture be fore undergoing epidural analgesia.