The Effect of Fluid Therapy Before Spinal Anesthesia on Prevention of Headache After Cesarean Section: A Clinical Trial

Abstract

Background: Despite numerous studies on postdural puncture headache (PDPH) and the factors affecting it, issues such as prevention methods and techniques that are associated with a lower prevalence of this complication are still under discussion and research. The aim of this study was to evaluate the effect of increasing fluid therapy of patients before surgery on the incidence of postoperative headache. Methods: This single-blind clinical trial study was performed on 60 patients undergoing elective surgery with spinal anesthesia based on the inclusion criteria in 2017 in Neyshabur. After obtaining the consent of the patients, the participants were randomly divided into two groups of intervention (A) and test (B) (30 people in each group). Data were created by self-checklist and visual analog scale (VAS) pain measurement criteria were recorded by phone during 4, 7, 24, 48, 72 hours, and 7 days after surgery. Results: In the study, the average headache increased up to 72 hours after surgery in the experimental group and in the intervention group up to 48 hours after surgery and then decreased. Conclusion: The results of our study generally showed that fluid therapy did not reduce headache, but showed decreasing trend of headache. According to the research results, more research is needed on the causes of headache after spinal anesthesia.

Evidence-based clinical practice guidelines on postdural puncture headache: a consensus report from a multisociety international working group

“…Increased oral intake of fluids is often encouraged, or intravenous fluid therapy is started to maintain or increase CSF production in patients with PDPH. While a single clinical trial noted no benefit of fluid therapy for prophylaxis, 189 no other studies have evaluated the benefit of either oral or intravenous fluid therapy exclusively for treating PDPH. Dehydration could worsen CSF production and headache.…”

Risk factors for post-spinal anesthesia headache and low back pain after orthopedic lower limb surgery in obese patients in Shohada hospital of Tabriz

“…Any method, no matter how good, will have complications, and spinal anesthesia has two: headache and low back pain (1). Although spinal anesthesia is simple to administer, it has a quick effect and provides good pain control while relaxing the muscles during surgery (2,3). The incidence of post-spinal anesthesia headache ranges from 2% to 32%, whereas the incidence of post-spinal anesthesia low back pain ranges from 5% to 55% (4).…”