Frequency of spinal headache among women undergoing caesarean section in Lady Aitchison Hospital, Lahore

Abstract

OBJECTIVE: To determine the frequency of spinal headache in obstetrical patients of different age group in general population

METHODS: A sample size of 251 pregnant women was calculated and total 255 women fulfilling the selection criteria were enrolled. All the patients underwent c-section. Anesthesia was given to all patients at sitting position. The patients received spinal anesthesia at the L2-3 or L3-4 interspaces using a midline technique. The patients received injections of 2.5–3.0 ml of 0.5% isobaric bupivacaine. For three days in a row, the patients were monitored and asked if they had any headaches. Gathered data was entered and analyzed by the SPSS (version 22). Comparison of different factors with spinal headache was done by applying Chi-square test. p-value <0.05 was taken as statistically significant.

RESULTS: Among all the participants, the mean age of the subjects was 32.18±5.5 years. The mean gestational age of the subjects was 37.23±1.04 weeks. The mean gravida was 3.34±1.39. The mean para was 2.01±1.02. The mean abortion was 0.37±0.66. The mean number of attempts was 1.97±0.632. According to spinal needle used distribution, 85(33.3%) were used 27G and 170(66.7%) were used 25G. Among all the participants, 126(49.4%) patients had spinal headache.

CONCLUSION: We advise against using the 25-gauge Quincke needle in the obstetric population due to the high frequency of headaches and the related treatment requirements. We also know that using small caliber pencil-point needles could further lower the incidence of post-dural puncture headaches, but they are currently very expensive, and many obstetric units in developing nations may not be able to purchase them.