Postdural Puncture Headache

Authoring Organizations

Publication Month/Year

August 15, 2023

Document Type


Country of Publication


Document Objectives

Postdural puncture headache (PDPH) can follow unintentional dural puncture during epidural techniques or intentional dural puncture during neuraxial procedures such as a lumbar puncture or spinal anesthesia. Evidence-based guidance on the prevention, diagnosis or management of this condition is, however, currently lacking. This multisociety guidance aims to fill this void and provide practitioners with comprehensive information and patient-centric recommendations to prevent, diagnose and manage patients with PDPH. These clinical practice guidelines for PDPH provide a framework to improve identification, evaluation and delivery of evidence-based care by physicians performing neuraxial procedures to improve the quality of care and align with patients’ interests. Uncertainty remains regarding best practice for the majority of management approaches for PDPH due to the paucity of evidence. Additionally, opportunities for future research are identified.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Treatment, Management

Diseases/Conditions (MeSH)

D006261 - Headache, D020773 - Headache Disorders, D051299 - Post-Dural Puncture Headache


headache, Postdural Puncture Headache, post-dural headache, PDPH

Source Citation

Uppal V, Russell R, Sondekoppam RV, et alEvidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working groupRegional Anesthesia & Pain Medicine Published Online First: 15 August 2023. doi: 10.1136/rapm-2023-104817

Supplemental Methodology Resources

Data Supplement, Data Supplement