Headache after neuraxial blocks: A focus on combined spinal-epidural anesthesia

The postdural puncture headache (PDPH) is a well-recognized complication of neuraxial anesthesia resulting from intentional or unintentional dural punctures. Combined spinal-epidural anesthesia (CSEA) is a widely used neuraxial anesthetic technique that provides fast, profound, reliable anesthesia with its spinal component and gives the ability to extend anesthesia and analgesia via the epidural catheter. Theoretically, the dura mater’s intentional puncture associated with the technique increases the risk of PDPH. Combined spinal-epidural techniques have been reported to be associated with a low incidence of PDPHs and as a result of a low incidence of epidural blood patches. This chapter tries to present a close look at the PDPH focusing on the CSEA.