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

Abstract

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.

Spiral Computed Tomography Imaging Analysis of Positioning of Lumbar Spinal Nerve Anesthesia under the Concept of Enhanced Recovery after Surgery

“…The CT localization had a good adoption value in lumbar spinal nerve anesthesia positioning. According to many clinical investigations, the improper intraspinal anesthesia puncture brings adverse consequences to patients, while the imaging puncture positioning brings benefits to patients to a certain extent [ 17 , 18 ]. The value of CT examination in lumbar spinal anesthesia is investigated.…”

Epidural blood patch in the treatment of severe post dural puncture headache after spinal anesthesia: A rare case report

“…The prevalence of PDPH was 42.6% in a study conducted at Felege Hiwot Referral Hospital in Bahirdar, Ethiopia, and large spinal needles and repeated attempts were independently associated risk factors for PDPH [4] .…”

“…This occurrence may have an impact on maternal satisfaction and healthcare quality. A normal BMI, frequent spinal injection attempts, and spinal injection with a needle size less than or equal to 22 gauge were all related to PDPH [4] .…”

“…At Debre Tabor General Hospital, the prevalence of PDPH was 20.2% [4] . According to a more recent study, the incidence of PDPH following a Dural puncture with an epidural needle could be as high as 76–85% [5] .…”

“…A Systematic review and meta-analysis conducted in Ethiopia estimated the pooled prevalence of PDPH among parturients who gave birth via cesarean section under spinal anesthesia to be 23.7% [4] .…”