Perinatal complications associated with neuraxial blocks

Klimkowicz, Agata; Rutyna, Rafał; Kotlińska-Hasiec, Edyta; Dąbrowski, Wojciech

doi:10.5603/gp.a2021.0047

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Childbirth is one of the most painful events in a woman's life, so many of them feel fear about the pain of labor [1]. Future mothers have always tried to find a way to alleviate it [2].…”

Section: Introductionmentioning

confidence: 99%

Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Bączek

Rychlewicz²,

Sys

et al. 2022

Ginekol Pol

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“…Childbirth is one of the most painful events in a woman's life, so many of them feel fear about the pain of labor [1]. Future mothers have always tried to find a way to alleviate it [2].…”

Section: Introductionmentioning

confidence: 99%

Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Bączek

Rychlewicz²,

Sys

et al. 2022

Ginekol Pol

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Incidence and Factors Associated with Postspinal Headache in Obstetric Mothers Who Underwent Spinal Anesthesia from a Tertiary Hospital in Western Uganda: A Prospective Cohort Study

Osman,

Muhumuza,

Fajardo

et al. 2023

Anesthesiology Research and Practice

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Background. The proportion of obstetric mothers reporting postspinal headache (PSH) in Uganda is high. The aim of this study is to determine the incidence and factors associated with postspinal headache among obstetric patients who underwent spinal anesthesia during cesarean section at a tertiary hospital in Western Uganda. Methods. A prospective cohort study was done on 274 consecutively enrolled obstetric patients at Fort Portal Regional Referral Hospital (FRRH) from August to November 2022. Pretested questionnaires were used to obtain the data needed for analysis. The data were entered into Microsoft Excel version 16, coded, and transported into SPSS version 22 for analysis. Descriptive statistics was used to determine the incidence of postspinal headache. Binary logistic regression was computed to obtain factors associated with postspinal headache. Results. The overall incidence of postspinal headache was 38.3% (95% CI: 32.5–44.4). Factors with higher odds of developing postspinal headache included using cutting needle (aOR 3.206, 95% CI: 1.408–7.299, p = 0.006 ), having a previous history of chronic headache (aOR 3.326, 95% CI: 1.409–7.85, p = 0.006 ), having lost >1500 mls of blood intraoperatively (aOR 6.618, 95% CI: 1.582–27.687, p = 0.010 ), initiation of ambulation >24 h after spinal anesthesia (aOR 2.346, 95% CI: 1.079–5.102, p = 0.032 ), allowing 2-3 drops of cerebrospinal fluid (CSF) to fall (aOR 3.278, 95% CI: 1.263–8.510, p = 0.015 ), undergoing 2 puncture attempts (aOR 7.765, 95% CI: 3.48–17.326, p ≤ 0.001 ), 3 puncture attempts (aOR 27.61, 95% CI: 7.671–99.377, p ≤ 0.001 ) and >3 puncture attempts (aOR 20.17, 95% CI: 1.614–155.635, p = 0.004 ), those prescribed weak opioids (aOR 20.745, 95% CI: 2.964–145.212, p = 0.002 ), nonsteroidal anti-inflammatory drug (NSAID) with nonopioids (aOR 6.104, 95% CI: 1.257–29.651, p = 0.025 ), and NSAID with weak opioids (aOR 5.149, 95% CI: 1.047–25.326, p = 0.044 ). Women with a body mass index (BMI) of 25–29.9 kg/m2 (aOR 0.471, 95% CI: 0.224–0.989, p = 0.047 ) and a level of puncture entry at L3-4 (aOR 0.381, 95% CI: 0.167–0.868, p = 0.022 ) had lower odds of developing PSH. Conclusions. The incidence of postspinal headache is still high as compared to the global range. This was significantly associated with needle design, amount of cerebro-spinal fluid lost, number of puncture attempts, body mass index, previous diagnosis with chronic headache, amount of intraoperative blood loss, time at start of ambulation, level of puncture entry, and class of analgesic prescribed. We recommend the use of a smaller gauge needle, preventing CSF loss, deliberate attempts to ensure successful puncture with fewer attempts, puncture attempts at L3-4, reducing intraoperative blood loss, earlier ambulation, and prescribing adequate analgesia to reduce the incidence of postspinal headache.

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Prevalence, common clinical presentations and severity patterns of post-dural puncture headache among parturients who underwent cesarean section using spinal anesthesia in western Uganda: a cross-sectional study

Hakizimana,

Jelle,

Ishimwe

2023

Int J Sci Rep

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Background: Post-dural puncture headache is a complication of regional blocks that results from intentional dural puncture during spinal anesthesia and unintentional dural puncture during epidural anesthesia. The aim of the study was to determine the prevalence, common clinical presentations and severity of post-spinal puncture headache among parturients who underwent cesarean section using spinal anesthesia in western Uganda. Methods: A cross-sectional study was conducted on 249 mothers who were consecutively enrolled in their 3rd post-partum day during the period from April 2022 to July 2022 from postnatal ward of Fort portal Regional Referral Hospital. The data needed for analysis was gathered using pretested questionnaires. Data was entered into microsoft excel version 16, coded and transported into SPSS version 22 for analysis. Descriptive statistics was carried out using SPSS version 22.0. Results: The prevalence of post-dural puncture headache among parturients who underwent cesarean section using spinal anesthesia was 81 (32.5%). Commonest clinical presentation being front/back headache 59 (72.8%), worsened with upright posture 81 (100%), coughing/sneezing 81 (100%) and improved on lying flat position 81 (100%). The commonest form was mild one 35 (43.2%). Conclusions: This study revealed a high prevalence of post-dural puncture headache as compared to studies done in the region which mainly presented as frontal/back with the commonest form being mild.

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Perinatal complications associated with neuraxial blocks

Cited by 3 publications

References 24 publications

Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Epidural anesthesia during childbirth — retrospective analysis of maternal and neonatal results

Incidence and Factors Associated with Postspinal Headache in Obstetric Mothers Who Underwent Spinal Anesthesia from a Tertiary Hospital in Western Uganda: A Prospective Cohort Study

Prevalence, common clinical presentations and severity patterns of post-dural puncture headache among parturients who underwent cesarean section using spinal anesthesia in western Uganda: a cross-sectional study

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