At a glance
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Two Dose Neuraxial Morphine for Prevention of Postdural Puncture Headache
In Brief
A Phase 4 clinical trial evaluating Morphine and Sterile normal saline for Postdural Puncture Headache. Completed, enrolled 44 participants across 4 sites.
Detailed Summary
Neuraxial analgesia (most commonly continuous epidural or combined spinal epidural) is the most effective modality available for pain relief during labor. Accidental dural puncture (ADP) with a large bore epidural needle and the resulting post-dural puncture headache (PDPH) is one of the most significant sources of anesthesia-related morbidity in parturients. Epidural blood patch (EBP) is the gold standard for treatment of PDPH, and although almost always effective, can result in another ADP, as well as low back pain and lower extremity pain. For this reason, effective measures to prevent PDPH when ADP occurs would be highly valuable. One small study in which 50 women were randomly allocated to receive 2 epidural injections of morphine or saline, demonstrated a beneficial effect of epidural morphine in decreasing the incidence of PDPH. This study aims to determine the efficacy of 2 doses of neuraxial (either epidural (EPID) or intrathecal) preservative-free morphine (PFM) to prevent headache after ADP in parturients.
Study Details
Timeline
Interventions
preservative free morphine given either via an epidural or intrathecal catheter
sterile normal saline, given either via an epidural or intrathecal catheter