Incidence of post dural puncture headache among mothers following caesarean section under spinal anesthesia at the General Hospital Kegalle, Sri Lanka

Abstract

Post Dural Puncture Headaches (PDPH) is a known complication of spinal anesthesia. Pregnant mothers who delivered their babies following spinal anesthesia especially suffer from this disturbing condition. Objective of this was to determine the incidence of PDPH among mothers who had caesarean sections in General hospital Kegalle. A descriptive cross sectional study was conducted involving all post natal units at General Hospital (GH), Kegalle. All the mothers who had spinal anesthesia during caesarean sections over 8 month period were considered as the study population. A case of PDPH is defined as a mother who complained a new onset headache following 12 hours gap after performing spinal anesthesia (onset between 12-48 hours). Two study instruments were used; a data sheet to extract relevant information from medical records and an interviewer administered questionnaire to elicit experience of mothers. Study population consisted of 422 mothers who had spinal anesthesia over a period of 8 months with a mean age of 30.6 (SD 5.9). Only Fifty seven (13.5%) reported PDPH. Commonest co-morbidity was neck pain (68.4%) followed by nausea (49.1%). Among them 21 (36.8%) had past history of headache. Six (10.5%) mothers with PDPH had pregnancy induced hypertension while 4 (7.0%) had GDM. Most of them got down from bed after 6 hours (73.2%). Among those PDPH, majority had spinal anesthesia with a needle of 24 G (92.8%), and among 95.6%, it was performed by a medical officer and in most of those instances performing person had an experience of 1-3 years in anesthesia. Experience less than 1 year was significantly associated with the development of PDPH (p<0.01). Prevalence of PPDH was 13.5% and commonest comorbidity was neck pain. Risk was more with less experienced performers.