4.1 Introduction

Recognition of inadvertent dural puncture is most important to obviate the risk of total spinal anaesthesia and to allow active measures to be taken to reduce the high incidence of distressing headache.

Dural puncture is indicated by the free-flow of C.S.F. Where doubt exists, the temperature of the fluid, crudely assessed, or the presence of glucose as determined by Dextrostix analysis, will confirm the nature of the fluid. Drugs should not be administered in increments of greater than 5 ml.