INCIDENCE OF HEADACHE AFTER DURAL PUNCTURE FOLLOWING CESAREAN SECTION: A COMPARATIVE ANALYSIS OF QUINCKE SPINAL NEEDLE SIZES IN A CROSS-SECTIONAL STUDY
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Keywords
Post-Dural Puncture Headache, Quincke Spinal Needle, Cesarean Section, Needle Gauge, Visual Analogue Scale
Abstract
Objective
The purpose of this study is to assess the incidence of post-dural puncture headaches (PDPH) in patients having cesarean sections in relation to various Quincke spinal needle sizes.
Duration of study and place of study : This study was conducted at Dubai Health,Hatta Hospital Dubai U.A.E from 1/1/2022 to 1/7/2023 .
Methodology
The present study is a cross-sectional analysis. The study included 200 female participants aged between 18 and 36, all classified as ASA I or II, undergoing cesarean sections. Depending on the needle size utilized, participants were divided into three groups at random: Group I (25G), Group II (26G), and Group III (27G). It was noted how many tries were needed to enter the subarachnoid space. Patients were monitored for PDPH throughout their hospital stay, including assessments of its occurrence, severity, and duration.
Results
The Visual Analogue Scale (VAS) was used to assess the severity of PDPH symptoms. A statistical study was carried out to record the incidence, severity, and duration of PDPH. The use of larger spinal needles and repeated puncture attempts were found to dramatically enhance the patients' risk of developing post-dural puncture hemorrhage (PDPH).
Conclusion
PDPH is more frequent, intense, and severe when using large-bore Quincke spinal needles. Therefore, to reduce the occurrence of PDPH, we suggest utilizing microbore needles with a diameter of 27G or smaller for cesarean sections.
References
2. Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003;91(5):718-29.
3. Vallejo MC. Post-dural puncture headache. Curr Opin Anaesthesiol. 2014;27(3):265-70.
4. Sng BL, Sia AT. Spinal needle design and size: a continuing evolution in the quest for safer neuraxial anaesthesia. Anaesthesia. 2021;76(1):107-15.
5. Halpern SH, Preston R. Post-dural puncture headache and spinal needle design. Can J Anaesth. 2015;62(1):65-72.
6. Leibold RA, Yeager MP, Mazuzan JE Jr, Bridger RF. Postdural puncture headache: the relationship to needle gauge. Anesthesiology. 1987;67(3):469-72.
7. Amorim JA, Gomes de Barros MV, Valença MM. Post-dural (post-lumbar) puncture headache: risk factors and clinical features. Cephalalgia. 2012;32(12):916-23.
8. Kwak KH. Postdural puncture headache. Korean J Anesthesiol. 2017;70(2):136-43.
9. Amorim JA, Valenca MM. Postdural puncture headache is a risk after spinal anesthesia. Clin Neurol Neurosurg. 2018;170:37-40.
10. Bezov D, Lipton RB, Ashina S. Post-dural puncture headache: Part I diagnosis, epidemiology, etiology, and pathophysiology. Headache. 2010;50(7):1144-52.
11. Kuczkowski KM. Post-dural puncture headache in the obstetric patient: an old problem. New solutions. 2014;42(3):101-8.
12. Peralta F, Devroe S. Any news on postdural puncture headache? Best Pract Res Clin Anaesthesiol. 2019;33(1):37-47.
13. Hwang K, Kwon JH, Lee S, Park Y, Kim H. Incidence of post-dural puncture headache after spinal anesthesia using different needle sizes in cesarean section: A prospective study. *Anesth Pain Med*. 2019;14(4):368-374.
14. Shrestha B, Pradhan S, Paudel S, Katuwal A, Shrestha S. A comparison of post-dural puncture headache between 24G, 26G, and 27G spinal needles in patients undergoing elective cesarean section: A randomized controlled trial. *BMC Anesthesiol*. 2020;20(1):100.
15. Terkawi AS, Mowafi HA, Khamis H, et al. Effect of needle gauge on the incidence of post-dural puncture headache: A randomized controlled trial. *Anesthesiology*. 2016;124(1):120-125.
16. Al-Ghanem SM, Bhatia S, Khoshhal H, et al. The effect of multiple puncture attempts on the incidence of post-dural puncture headache in patients undergoing spinal anesthesia: A prospective observational study. *Saudi J Anaesth*. 2018;12(3):423-428.
17. Nair AS, Alagarsamy P, Sreedharan K, et al. Risk factors for post-dural puncture headache: A meta-analysis. *BJA Educ*. 2022;22(6):223-230.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Adel Hussein dahshan
Senior Anesthesia specialist, Dubai Health,Hatta Hospital Dubai U.A.E.
Sherif Atef Gomaa Aly
Senior Anesthesia specialist, Dubai Health,Hatta Hospital Dubai U.A.E.
Amr Ahmed Abdelrahman Abdelwahed
Anesthiologist specialist, Dubai Health,Hatta Hospital Dubai U.A.E.
Khalid A.M Eltayib
Anesthiologist specialist, Dubai Health,Hatta Hospital Dubai U.A.E.
Mohammed Nemr Abdallah Ahmed Aburezeq
Anesthesia specialist, Dubai Health,Hatta Hospital Dubai U.A.E.
Tarek Mohamed Refat Elhefni
Consultant Anethesia, Dubai Health,Hatta Hospital Dubai U.A.E.