alexa Use of Cosyntropin for Treatment of Refractory Post Dur
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
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Case Report

Use of Cosyntropin for Treatment of Refractory Post Dural Puncture Headache (PDPH): Case Report and a Suggested Algorithm

Andaleeb Abrar Ahmed1*, Sanjib Adhikary2, Thomas A.Verbeek2 and Sonia Vaida3

1Resident, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA

2Assistant Professor of Anesthesiology, Penn State Hershey Medical Center, Hershey, PA, 17033, USA

3Professor of Anesthesiology, Penn State Hershey Medical Center, Hershey, PA, 17033, USA

*Corresponding Author:
Andaleeb Abrar Ahmed
Resident, Penn State Milton S. Hershey Medical Center
500 University Drive
BMR-H187, Hershey, PA 17033, USA
Tel: 001-717-531-5522
Fax: 001-717-531-0826
E-mail: [email protected]

Received date: September 10, 2012; Accepted date: October 09, 2012; Published date: October 27, 2012

Citation: Ahmed AA, Adhikary S, Verbeek TA, Vaida S (2012) Use of Cosyntropin for Treatment of Refractory Post Dural Puncture Headache (PDPH): Case Report and a Suggested Algorithm. J Anesth Clin Res 3:259. doi: 10.4172/2155-6148.1000259

Copyright: © 2012 Ahmed AA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Postdural Puncture Headache (PDPH) is a frequent complication of neuraxial blockade. Use of ACTH or its synthetic analogs for the treatment of PDPH has been reported in the literature since 1994. We describe a case of refractory PDPH in a 36 year old female despite two epidural blood patches (EBPs). Evidence-based algorithmic management of PDPH has never been reported in Anesthesiology literature. Based on the available evidence we developed an opinion-based algorithm for management of PDPH. The associated case report highlights the role of ACTH and the importance of algorithmic management of PDPH.

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