Incidence of PDPH following spinal anesthesia in obstetric patients undergoing cesarean section in our setup

Abstract

Background: Post dural puncture headache has remained a well-known complication of spinal anaesthesia. The potentially serious nature of this complication necessitates inclusion of informed consent involving any procedure that may result in post dural puncture headache. Aim: To determine the overall incidence of post dural puncture headache in obstetric patients in our set up and determine the onset, duration and severity of postdural puncture headache. Methods: This prospective, observational study was conducted in Postgraduate Department of Anaesthesiology, Critical Care and was done in Lalla Ded Hospital, an associated hospital of Government Medical College, Srinagar on patients who underwent cesarean section under spinal anaesthesia for incidence, onset, duration and severity of postdural puncture headache. Results: Incidence of post dural puncture headache was 10.6% (102 of 960) in our study patients, mean time of onset of post dural puncture headache was 26.4+8.92 hours, severity of PDPH was mild in 62 (60.8%) patients, moderate in 39 (38.2%) patients and severe in 1 (1.0%) of the patients. The mean duration of PDPH was 5.3+2.89 days. Conclusion: To prevent PDPH, the use of size 26 gauge quincke’s needles may be encouraged as this study has shown but cost consideration especially in the developing countries setting is always a limiting factor. Conservative measures as treatment for PDPH, should be tried first in view of the good response obtained for all the cases of PDPH in this study.