Post-Dural Puncture Headache after Caesarean Section under Spinal Anesthesia: Local Experience at Liaqat Memorial Hospital, Kohat Pakistan

Post-Dural Puncture Headache after Caesarean Section

Abstract

Objective: To assess the incidence and risk factors of Post-Dural Puncture Headache (PDPH) in parturients undergoing caesarean sections under spinal anesthesia. Study Design: Descriptive cross-sectional prospective study. Settings: Department of Medicine, Liaqat Memorial Hospital, Kohat Pakistan. Duration: June to December 2023. Methods: A total of 346 patients were included, with data collected on needle gauge, needle approach, PDPH incidence, Visual Analogue Scale (VAS) scores, and comorbidities. Statistical analysis, including chi-square and t-tests, was used to evaluate the associations between these variables. Results: The results revealed a higher incidence of PDPH in patients who received spinal anesthesia with a 25G Quincke needle (67 cases) compared to those with a 27G Quincke needle (21 cases) on Day 1 (p-value = 0.001). The paramedian approach resulted in fewer cases of PDPH (30 cases) compared to the midline approach (58 cases) (p-value = 0.02). The VAS scores for mild PDPH were significantly lower (mean: 3.2) compared to moderate (mean: 5.6) and severe (mean: 8.2) cases on Day 1. Severe PDPH patients had a higher readmission rate (20 cases) compared to mild (5 cases) and moderate (15 cases) groups (p-value = 0.005). Conclusion: The use of a 27G Quincke needle and the paramedian approach minimizes PDPH. These findings provide valuable insights into the management of spinal anesthesia in secondary care settings and suggest further research into prevention and treatment strategies for PDPH.