Multimodal Approach to the Intrathecal Catheter for Obstetric Accidental Dural Puncture

Study Overview
=================
Brief Summary
-----------------
Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache.

Detailed Description
-----------------
The aim of this study the effectiveness of a protocol implemented in our department, according to the recommendations of good practice, on the reduction of the use of blood patchs in patients who have had an accidental dural puncture during the implementation of their spinal anesthesia, in order to prevent the use of the blood patch. In addition, intensity of headaches is evaluated.

Official Title
-----------------
Multimodal Approach to the Intrathecal Catheter for Obstetric Accidental Dural Puncture

Conditions
-----------------
Spinal Anesthetics Causing Adverse Effects in Therapeutic Use

Intervention / Treatment
-----------------
* Other: collection of data from the medical record


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients having an accidental dural puncture during the installation of an epidural anesthesia Exclusion Criteria: Patients without accidental dural puncture

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients having an accidental dural puncture during the installation of an epidural anesthesia<br>patients having an accidental dural puncture during the installation of an epidural anesthesia will be included. Analysis datas of medical record. | Other: collection of data from the medical record<br>* collection of data from the medical record: During epidural space puncture = cerebrospinal fluid (CSF) reflux, presence of glucose / strip, saline injection, intrathecal catheter insertion, intrathecal levobupivacaine and sufentanil injection, catheter insertion time, number of punctures, function of the person performing the procedure. Analgesia and hemodynamics during labor, blood pressure, pulse rate, amount of local anesthetic used, whether emergency cesarean section was performed Demographic data (age, weight, height, body mass index (BMI)) Post-partum monitoring of decubitus or orthostatic headaches, intensity, any other associated clinical signs Analgesics used and their efficacy The use of one or more blood patches, with the volume injected and their efficacy Identification of the breach during epidural analgesia or after delivery Call the patient at 1 week to reassess the episode and its consequences.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of epidural blood patch | Collect from medical records. | Day: 7 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| headache intensity | Collect from medical records. | Day: 7 | 
| Timeframe for blood patching | Collect from medical records the Timeframe for blood patching | Day: 0 | 
| Number of blood patches required | Collect from medical records. | Day: 7 | 
| Safety of the technique by number of adverse event | Collect from medical record the adverse event (complications). | Day: 7 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Accidental dural puncture, Epidural blood patch, Intrathecal catheter, Postdural puncture headache, Epidural anesthesia, Obstetrics