Persistent post-dural- @entity9737 XXXX treated with epidural infusion of dextran.

@entity1 @entity913 @entity10 @entity6413 @entity9737
A retrospective review was done on medical records of 13 @entity1 with persistent post-dural- @entity9737 headaches after one or more epidural blood patches. @entity10 occurred in nine @entity1 with @entity6413 after "wet taps" while performing epidural blocks. In two @entity1 post-dural- @entity9737 @entity10 appeared after long term implanted intrathecal catheters were removed. In two other cases @entity10 developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three @entity1 were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran-40 was given followed by an infusion of 3 mL/hr, until 12 hours after the @entity10 and any other related symptoms subsided. In all @entity1 the @entity10 disappeared within 20 hours after initiating therapy (9.55 mean hours, SD +/- 0.79). In five @entity1 @entity10 ceased in less than five hours. Nausea and photo- @entity913 subsided earlier. @entity1 with post-dural- @entity9737 @entity10 resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran-40.
