European Journal of Molecular & Clinical Medicine

Abstract

Aim: Assessment of the prevalence and associated risk factors of post dural puncture
headache (PDPH) after cesarean section delivery under spinal anesthesia
Methods: This Cross Sectional study conducted in the Department of Anesthesia, Madha
Medical College Research Institute, Kovur, Chennai, Tamil Nadu, India for the period of 1
year. The entire procedures were performed at sitting position. The backside of the patients
was cleaned with Iodine and alcohol. Spinal anaesthesia was done using a midline approach
at the L2-3 or L3-4 interspaces by using different size of spinal needles and 0.5 % isobaric
bupivacaine 2.5-3.0ml was injected.
Results: The 100 Patients were included in this study with fulfilling the criteria. 8 patients
had a previous history of spinal anesthesia exposure and 3 of them complained a PDPH like
headache after the procedure. All patients had given spinal anesthesia on sitting position. 23
G needle is the most frequently used spinal needle. There were 1 cases (1%) diagnosed as
failed block which were converted to general anesthesia. Hosmer-Lemeshow test of goodness
of fit was performed to check the appropriateness of the model for analysis. Variables found
to be significant at a binary logistic regression were: needle size and number of attempts.
After analysis with multivariate logistic regression needle size and number of attempts were
found to be significant at p-value<0.05. Size of the needle used to administer spinal
anesthesia is significantly associated with the development of PDPH. In this study PDPH
was present in 43 patients (43%).
Conclusion: In conclusion, the prevalence of PDPH was higher, 43% compared with most
other studies.