Use of Cosyntropin for Treatment of Refractory Post Dural Puncture Headache (PDPH): Case Report and a Suggested Algorithm
- *Corresponding Author:
- Andaleeb Abrar Ahmed
Resident, Penn State Milton S. Hershey Medical Center
500 University Drive
BMR-H187, Hershey, PA 17033, USA
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.