OBSTETRIC ANESTHESIA DIGEST

explained to the mother in 151 units; 18 did not mention either complication. All units obtained either verbal (57%) or written (43%) consent before a blood patch was performed. In 46 units, women were discharged within a few hours of the procedure, in 60 after 6 h, and in 51, the next day; in 11 units the mother was kept for 24 h. Of the 99 follow-up questionnaires sent, 93 were returned. The most common indications for the use of intrathecal catheters were to avoid another dural puncture and to allow immediate analgesia for labor. Many respondents, however, were uncertain about whether intrathecal catheters completely or partially reduced the incidence and severity of PDPH. Catheters were removed when labor or the operative procedure ended in 67 units, to avoid the dangers of catheter misuse and the chance of infection. Based on this survey, compared with results in 1993, the most significant change in practice was the insertion of the epidural catheter intrathecally when accidental dural puncture was diagnosed. A procedure that was used in only 2 units (1%) in 1993 is now a common practice in up to 100 units (59%).