Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis

Lee, Sang Il; Sandhu, Shabaaz S.; Djulbegoviĉ, Benjamin; Mhaskar, Rahul

doi:10.1111/jebm.12311

Cited by 21 publications

(19 citation statements)

References 36 publications

(90 reference statements)

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“… 11 According to a meta-analysis study, pencil-point needle is helpful to reduce the risk of PDPH (risk ratio (RR) = 0.33, 95% CI = 0.25–0.45). 20 A study done to compare 25- and 27-gauge needle showed that 14.5% of 25-gauge needle experienced PDPH compared with 3.2% of 27-gauge needle with statistically significant difference (p = 0.027). 3 , 23 Another study comparing 22-, 25-, and 26-gauge spinal needles on the incidence of PDPH revealed that 33%, 4%, and 5% of the participants develop PDPH, respectively, with the overall incidence of 8.3% (p = 0.003).…”

Section: Discussionmentioning

confidence: 98%

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Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

et al. 2021

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Introduction and Objective: Postdural puncture headache is one of the most frequent late complications of spinal anesthesia. There are different factors that might predispose for postdural puncture headache. Therefore, the main aim of this study was to assess the incidence of postdural puncture headache and its associated factors for parturients who gave birth by cesarean section under spinal anesthesia. Methods: Hospital-based longitudinal study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regression were used to measure the association of factors with the presence of postdural puncture headache. A p-value of ⩽0.05 was used to decide statistical significance for multivariable logistic regression. Result: A total of 119 parturients were participated in this study. The incidence of postdural puncture headache was 20.2%. According to multivariable logistic regression, having previous spinal anesthesia (adjusted odds ratio = 7.028; 95% confidence interval = 2.377–20.781; p = 0.0001), using 20- and 22-gauge needle (adjusted odds ratio = 4.206; 95% confidence interval = 1.247–14.187; p = 0.021), and repeated attempt (adjusted odds ratio = 4.699; 95% confidence interval = 1.594–13.872; p = 0.05) had statistically significant association with postdural puncture headache. Conclusion: Larger gauge needle size, repeated attempt, and previous spinal anesthesia might increase the incidence of postdural puncture headache.

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Section: Discussionmentioning

confidence: 98%

“…The incidence of PDPH may vary with different needle size and types. 6 , 20 – 22 The use of a large caliber or cutting needle may associate with high incidence of PDPH. 15 The incidence of headache after spinal anesthesia varies greatly among the previous studies with different factors.…”

Section: Discussionmentioning

confidence: 99%

Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

et al. 2021

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“…However, recent studies have reported that the rates of PDPH were 5.6% and 17.2% 23,24 . The difference was mainly due to the use of different types and sizes of puncture needles 25,26 . In our study, we used the pencil-point spinal needles and the rate of PDPH was 8%.…”

Section: Discussionmentioning

confidence: 99%

Intravertebral Anaesthesia For cesarean section

Wang

Xie

Chun

et al. 2019

Preprint

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BACKGROUND: Although epidural and spinal anaesthesia in patients undergoing cesarean section is the general choice recently, both of the two anesthesia methods still have imperfects. Caudal anesthesia has been considered more appropriate for gynecological surgery. However, there is a lack of experiments on the effects of epidural block combined with caudal block anaesthesia for cesarean section. METHODS: One hundred and fifty patients undergoing elective cesarean section were recruited to this clinical trial and randomized to receive epidural block, subarachnoid block, and epidural block combined with caudal block. The primary objective was to compare and evaluate the clinical efficacy of three groups. Secondary outcomes included side effects and the quality of intraoperative and postoperative comfort assessment. RESULTS: The times to cryanaesthesia at T10 and time to maximum motor block were shorter in group SAB. The maximal sensory blockade spinal segments of group SAB(15.18±0.90)and EAC (14.74±1.16)were much more than group EPB(10.74±1.77). Compared to group EPB(155.40±13.28) and EAC(160.70±12.58), the duration of complete regression of motor block was longer in group SAB(190.00±13.25). The intraoperative quality of anesthesia was judged by the gynecologist was excellent in group EAC and SAB(P=0.005), and by the parturients was only best in group EAC(P=0.001). The parturients felt more comfortable after surgery in group EPB and group EAC(P=0.007). CONCLUSIONS: Epidural block combined with caudal block anaesthesia can achieve the same anesthetic effect as spinal anaesthesia which is bettter than epidural anaesthesia for elective cesarean section, and have the highest level of intraoperative and postoperative comfort for parturient.

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“…General anesthesia is superior to spinal anesthesia in terms of providing more rapid induction, better cardiovascular stability and respiration control, and the low likelihood of hypotensive attacks. However, aspiration of gastric contents and intubation diffi culties are more common when using general anesthesia in pregnant women and comprise the main disadvantages of this method for cesarean sections [8,9]. Apgar score and cord blood gas analysis are parameters used to assess the well-being of the newborn [10].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Anesthesia Techniques Used in Cesarean Deliveries on the Neonate - Anesthesia Techniques and Neonate?

Balkan¹,

Özbaş²,

Tontu³

et al. 2019

Am J Anesth Clin Res

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Background: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn, research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. Methods: This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1 rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl. Results: There were no significant differences between Group SA, Group P, and Group T in terms of delivery time; neonatal 1- and 5-min Apgar scores; neonatal jaundice rates; neonatal systolic, diastolic, or mean blood pressure or peak heart rate; neonatal intensive care requirement; pH, PCO2, PO2 values in cord blood gas; or neonatal glucose and lactate values. The rate of ephedrine use was significantly higher in Group SA than in Group P and Group T. Maternal satisfaction score was higher in Group SA at postoperative 4 hours and in Group P at 24 hours. The number of newborns taken into intensive care unit in Group T was significantly higher in the 1st hour, 4th hour, 5th hour and total. Respectively p value (0.006, 0,048, 0,048, and 0,005). Pain on injection was present in 55% of patients (n = 81), mild in 36% (n = 54), and severe in 18% (n = 27). Myoclonies occurred in 4% of patients (n = 7) and local rash in 6% of patients (n = 10). Differences between formulations did not reach statistical significance. Conclusion: None of the three anesthesia methods showed superiority after elective cesarean delivery. However, spinal anesthesia and general anesthesia with propofol are more appropriate for pregnant women in terms of effects on the neonate.

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Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis

Cited by 21 publications

References 36 publications

Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

Intravertebral Anaesthesia For cesarean section

Comparison of Anesthesia Techniques Used in Cesarean Deliveries on the Neonate - Anesthesia Techniques and Neonate?

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