![]() A diagnosis of PDPH was made, and an EBP was performed. The patient did not have fever or focal neurologic deficits. ![]() She returned the following day to the emergency room because of exacerbation of symptoms. On the first postdelivery day, the catheter was removed and the patient was discharged to her home. The headache was treated with analgesics and hydration, with partial alleviation of symptoms. The catheter was left in the subarachnoid space, and the patient delivered a healthy baby within the hour. The patient received a test dose of local anesthetic, yielding almost immediate loss of sensation to spinal dermatome level T4, with motor paralysis and shortness of breath. No paresthesia or pain was present upon catheter insertion. During insertion of the epidural needle, the patient felt a distinct sensation of membrane puncture followed by a postural headache and tinnitus, without nausea or vomiting. In the lateral decubitus position, a 20-gauge epidural catheter was inserted through an 18-gauge Tuohy needle. The patient had no history of back pain or migraine headaches. ![]() During her previous three deliveries, she received epidural analgesia without any difficulty or complications. A 39-yr-old, healthy woman, G5P4Ab0LC4, was admitted to the delivery room of another hospital in active labor at term. ![]()
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