Audiovisual Assessment After Dural Puncture During Epidural Placement in Obstetric Patients
Audiovisual Assessment After Dural Puncture During Epidural Placement in Obstetric Patients
The study involves assessment of hearing and visual complications along with headache after
 accidental dural puncture in patients receiving epidurals. Hearing loss will be assessed by
 clinical examination and audiometry testing, while visual complications will be assessed by
 clinical examination. The patients will receive standard treatment for headache in the form
 of drugs and if required an epidural blood patch ( injecting patient's blood in the epidural
 space). The course of these complications and response to treatment will be investigated over
 a period of time.

 Audiometry results from patients with dural puncture will be compared to those of patients
 who also had epidurals, but without a dural puncture.

 The investigators hypothesize that audiovisual complications occur more frequently in
 patients having accidental dural puncture with epidural needle and that the symptoms resolve
 with the administration of epidural blood patch.
Although many studies have reported auditory complications after spinal, none have been done
 in obstetric patients with accidental dural puncture with epidural needle. Long term follow
 up of these complications has been unknown. The incidence of both auditory and visual
 complications is likely to be high in patients getting accidental dural puncture with 17G
 Touhy epidural needle as compared to small gauge spinal needles. Several case reports have
 been reported with such temporary and permanent hearing and visual loss. A prospective study
 to understand these complications is required. The study will provide us with the true
 incidence of audiovisual complications of dural puncture with an epidural needle. Early
 intervention in cases of dural puncture may alleviate or halt symptoms.
Inclusion Criteria:

 -  Parturients having accidental dural puncture during epidural placement for labour
 analgesia.

 -  Patients who give written informed consent to participate in the study.

 -  Dural puncture with 17G Touhy needle with/out headache

 -  Postural headache after 24 hours of epidural

 -  Labouring women undergoing vaginal or Cesarean delivery

 -  For the control group, patients with no dural puncture during epidural placement

 Exclusion criteria:

 -  Patients refusing to consent

 -  Dural puncture with spinal needle