Abstract | BACKGROUND: METHOD: The study population included 132 women with an accidental dural puncture over a three-year period (June 1, 2018 to Oct 31, 2021) at a large tertiary-care center. Patient electronic medical records were reviewed for patient characteristics, prophylactic administration of cosyntropin, PDPH diagnosis, and need for epidural blood patch. Typically, 1 mg of cosyntropin was administered as an intravenous bolus or infusion post-delivery. The propensity score was calculated based on the following factors: age, body mass index, and placement of an intrathecal catheter. Patients were matched allowing 10% variation in scores to reduce potential treatment assignment bias. RESULTS: A total of 115 patients were included in the final analysis. Intravenous cosyntropin was administered to 65 patients (55.6%). Among those who received cosyntropin, 37 (56.9%) developed PDPH compared with 29 patients (58%) in the no- cosyntropin group (P = 0.08). Epidural blood patch was performed in 21 patients (56.8%) who received cosyntropin and 13 patients (61.7%) who did not (P = 0.70). CONCLUSION: Prophylactic administration of cosyntropin is not associated with a reduced incidence of PDPH.
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Authors | M Liu, A Mitchell, A Palanisamy, P M Singh |
Journal | International journal of obstetric anesthesia
(Int J Obstet Anesth)
Vol. 56
Pg. 103922
(11 2023)
ISSN: 1532-3374 [Electronic] Netherlands |
PMID | 37651920
(Publication Type: Journal Article)
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Copyright | Copyright © 2023 Elsevier Ltd. All rights reserved. |
Chemical References |
- Cosyntropin
- Adrenocorticotropic Hormone
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Topics |
- Pregnancy
- Humans
- Female
- Cosyntropin
- Post-Dural Puncture Headache
(etiology)
- Anesthesia, Obstetrical
(adverse effects)
- Retrospective Studies
- Adrenocorticotropic Hormone
- Spinal Puncture
(adverse effects)
- Blood Patch, Epidural
(adverse effects)
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