Magnitude of post dural puncture headache and associated factors in obstetric mothers undergone spinal anesthesia for caesarean section

Abstract

Background: Although modern anesthesiology has made great progress in the last decades, neuraxial anesthesia (NA) is still the keynote of regional blockade. It is popular for its effectiveness in producing anesthesia and analgesia. As the NA techniques popularly used in clinics, post dural puncture headache (PDPH), a common iatrogenic complication resulted from post-spinal taps or accidental dural puncture (ADP) subsequent to epidural block, frequently reported and becomes a challenging to health caregivers. The objective of the study was to assess the magnitude of post dural puncture headache (PDPH) and Associated Factors in Obstetric Mothers Undergone Spinal Anesthesia for Cesarean Section from February 1 – June 30, 2018 Methods and Materials: Institutional based cross-sectional study design conducted in Dilchora Hospital and Sabian Primary Hospital from February 1 – June 30, 2018. 391 obstetric mothers was systematically selected every 2 other patient interval. The data was collect from both patient chart review and interview using structured checklist. Results: 85/391 (21.7%) obstetric mothers present with headache characteristic of post-dural puncture headache (PDPH). Larger gauge spinal needle [AOR= 3.105: 95% CI (1.116 - 8.638), P = 0.03] and multiple spinal attempts [AOR 0.374; 95% CI (0.220 - 0.635) P = 0.000] was statistically significantly related with PDPH after Spinal anesthesia. Conclusion and Recommendation: In our study, we observe a relatively higher prevalence of PDPH (21.7%), as compared to other literatures. Large gauge spinal needles (≥ 23 G) and multiple spinal attempts is also find statistically significantly related with PDPH after Spinal Anesthesia. In order to decrease the higher prevalence of PDPH in those Hospitals, Anesthetists should avoid utilization of large gauge spinal needles, and repeated dural puncture during Spinal Anesthesia.