Incidence and associated factors of post dural puncture headache after cesarean section delivery under spinal anesthesia in University of Gondar Comprehensive Specialized Hospital, 2019, cross sectional study

Abstract

Background: Post-Dural puncture headache is a major complication of neuraxial anesthesia that can occur following spinal and epidural anesthesia. It is, postural, and frontal and relieved when the patient is supine position and aggravated during standing, sitting, coughing. Therefore, we aimed to determine the incidence and factors associated with post dural puncture headache following cesarean section under spinal anesthesia. Methods: An institution based cross sectional study was conducted from March 01 to May 29, 2019. A total of 384 willing patients were included in the study after obtaining ethical consent. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) window version 20. Descriptive statistics, cross-tabs and binary logistic regression analysis were performed to identify the association between post dural puncture headache and independent variables. The strength of the association was presented using adjusted odds ratio with 95% confidence interval and p-value<0.05 was considered as statistically significant. Results: The incidence of post dural puncture headache was 31.3% (95% CI: 26.8, 35.9) with response rate of 92.5%. Majority of the patients who developed it were on the 2nd day with majority of the pain being moderate. In this study body mass index, Size of spinal needle, number of attempt and educational status of anesthetists were significantly associated with it. Conclusion: In this study non-obese patients, big spinal needles, repeated number of attempts and educational status of anesthetists were the independent associated risk factors for post dural puncture headache. Highlights

Effect of Intravenous Ketamine on Hypocranial Pressure Symptoms in Patients with Spinal Anesthetic Cesarean Sections: A Systematic Review and Meta-Analysis

“…However, weight gain during pregnancy leads to subcutaneous fat thickening and unclear exposure between vertebrae, which inevitably increases the risk of spinal anesthesia and post-puncture complications [ 5 ]. Hypocranial pressure caused by cerebrospinal fluid outflow is one of the common complications after spinal anesthesia, mainly manifested as headache after dural puncture [ 6 ], especially in terms of obstetric anesthesia [ 7 ]. In addition, low intracranial pressure can cause nausea and vomiting [ 8 ].…”

Prevalence of Dural Puncture headache after caesarean section at a Tertiary Hospital in the Gambia

“…A cross sectional study conducted in Ethiopia had incidence of post dural puncture headache 31.3% and (32.5%) in Cairo University, Egypt (8, 13). These studies were all prospective just like our study, but the population size and the gauge of the needle differs.…”

“…A cross sectional study conducted in Ethiopia had incidence of post dural puncture headache 31.3% (8).…”

“…However, a retrospective cohort study conducted in Jordan reported a lower incidence of PDPH (6.3%) (7). A cross sectional study conducted in Ethiopia had incidence of post dural puncture headache 31.3% (8).…”

Incidence and Risk Factors of “Postdural Puncture Headache” in Women Undergoing Cesarean Delivery under Spinal Anesthesia with 26G Quincke Spinal Needle, Experience of Medical College in Rural Settings in India 2019

“…PDPH is more common in the young and female compared to the male.13- 18 It is two times more common in nonpregnant women than among men. [ 19 20 21 22 23 24 ] Women for cesarean section are particularly at higher risk because of their young age and sex. [ 25 26 27 28 29 30 ]…”