Comparison of post-dural puncture headache- incidence and severity in obstetric patients after spinal anesthesia for caesarean section with 25G and 27G quincke needle

2017 ◽  
Vol 5 (2) ◽  
pp. 596 ◽  
Author(s):  
Sumaya Syed ◽  
Nargis Qayoom ◽  
Shazia Naaz ◽  
Khalida Mushtaq ◽  
Aabid Hussain Mir ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Study Patient ◽  
Age Group ◽  
Inclusion Criteria ◽  
Post Dural Puncture Headache ◽  
Double Blinded ◽  
Prolonged Hospital ◽  
High Degree

Background: The use of neuraxial anesthesia for caesarean section has dramatically increased in last 2 decades because it is easier to perform, safe to the mother and the fetus, and has a high degree of success rate. However, post-dural puncture headache is a well-known complication of spinal anesthesia. It is a common and incapacitating compliation following dura-arachnoid puncture and results in increased morbidity, prolonged hospital stay, increased cost, and patient dissatisfaction.Methods: It was a double-blinded comparative study conducted on 75 consecutive pregnant patients meeting the inclusion criteria of the study. Patient and anesthesiologist involved in collection of data were blinded to the gauge of the needle used. Standard anesthesia protocol was followed in all the patients and spinal anesthesia performed using 25G Quincke needle in 38 patients and 27G Quincke needle in 37 patients.Results: we included 75 consecutive patients in the age group 20-35 years in the study. Overall incidence of PDPH was 14.67% (11/75) in present study. 23.68% (9/38) and 5.4% (2/37) patients who received spinal anesthesia with 25G and 27G needles respectively developed PDPH. Difference was statistically insignificant.Conclusions: The incidence of PDPH was less in patients who underwent caesarean section under spinal anesthesia with 27G needle compared to that of patients in whom block was performed using 25G needles. However, there was no definite advantage of 27G Quincke needle over 25G Quincke needle as far as the incidence of PDPH is concerned.

scholarly journals Incidence of post dural puncture headache in parturients following early ambulation and recumbency

2017 ◽  
Vol 4 (2) ◽  
pp. 14-20
Author(s):  
Niroj Hirachan
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Muscle Relaxation ◽  
Early Mobilization ◽  
Chi Square ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Chi Square Test ◽  
Group A

Introductions: Spinal anesthesia is a safe and acceptable technique for patients undergoing caesarean section because it provides both excellent analgesia and muscle relaxation. Post Dural Puncture Headache (PDPH) is frequently reported complication after spinal anesthesia. This study evaluates the incidence of PDPH following early mobilization and recumbency after caesarean section. Methods: This prospective, randomized comparative interventional study included 100 parturients women of age 18 to 45 years, ASA I and II, randomly divided into two groups – Ambulatory ‘A’ and Recumbent ‘R’. At the end of caesarean section, patients were advised to either lie in recumbent position for 24 hours or mobilize as soon as they become ambulatory after spinal aneshthesia. Occurrence of headache were recorded at 24 hours, 72 hours and 7th day. Software SPSS 16, chi-square test was used for proportions like incidence and severity of PDPH; p<0.05 was taken as significant. Results: The incidence of PDPH was statistically not different (p = 0.361) in Group R 8% (4 patients) and in Group A 6% (3 patients). In both the groups, the severity of headache was mild to moderate with only mild headaches in the Group A (p = 0.549). Conclusions: Early ambulation following spinal anesthesia for caesarean section did not increase the incidence of PDPH in parturients.  

scholarly journals Post - Spinal Anesthesia Headache Treatment: a literature review

2021 ◽  
Author(s):  
Gabriel Aranha Sousa Maués ◽  
Rafaela Seixas Pinho ◽  
Aline Cristine Passos de Souza
Keyword(s):  
Literature Review ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Autologous Blood ◽  
Inclusion Criteria ◽  
Invasive Procedures ◽  
Exclusion Criteria ◽  
Study Objective ◽  
Post Dural Puncture Headache ◽  
Headache Treatment

Background: Post-spinal anesthesia headache is a common complication of this procedure due to the loss of cerebrospinal fluid through the puncture orifice. Resolution may be spontaneous or require interventions such as presented in this study. Objective: To address the most relevant and current aspects of post-spinal anesthesia headache treatment. Methods: Literature review based on Pubmed, Scielo and Google Scholar databases, having as inclusion criteria articles of great published in English, Portuguese and Spanish in the period 2016 to 2021 and exclusion criteria articles published outside that period. Results: Post-spinal anesthesia headache or post-dural puncture headache (DPC) is divided into disabling headache and non-disabling headache in order to guide its management. In non-disabling headache, analgesics, caffeine and hydration are used. In disabling headache, blood-patching can be performed from the injection of autologous blood in the epidural space in order to buffer the puncture hole. In addition to this technique, there is the blockade of the sphenuous- palatine ganglion, which is performed by applying 5% lidocaine with the aid of a swab, introduced perpendicularly to the nasopharynx, where the sphenuous ganglion is located – palatine ,inhibiting vasodilation from the blockage of parasympathetic transmission and thus decreasing the intensity of headache, considering the approachless invasive and with fewer complications, but that needs to be better studied for its application. Conclusion: The treatment of mistraining cppd from conservative to more invasive procedures and with a higher risk of complications. Due to the above, studies should be encouraged to expand the therapeutic arsenal of this disabling headache.

scholarly journals Post dural puncture headache

1970 ◽  
Vol 32 (2) ◽  
pp. 30-32
Author(s):  
J Singh ◽  
S Ranjit ◽  
S Shrestha ◽  
T Limbu ◽  
SB Marahatta
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Age Group ◽  
Institute Of Medicine ◽  
Common Complication ◽  
Post Dural Puncture Headache ◽  
Male And Female ◽  
Cerebrospinal Fluid Leaks ◽  
Study Questionnaire ◽  
Made In

Introduction: Post dural puncture headache occurs as the cerebrospinal fluid leaks out from the breach that the needle has made in the dura. The incidence of Post Dural Puncture Headache (PDPH) is a common complication after spinal anesthesia. The objective of our study is to find out incidence of PDPH in patients undergoing surgery under spinal anesthesia in Dhulikhel Hospital. Methods: 120 patients who underwent spinal anesthesia were selected for the study. Questionnaire was used to assess the post dural puncture headache 24 hours after surgery. Headache, if present in frontal or occipital areas which increased when sitting or situational movement and relieves by lying in flat position were considered as PDPH. Results: PDPH was observed in 25% of the patients. The incidence of PDPH is 30% and 70% in male and female respectively. It was 2.33 times more in age group 18-30- years than 31-45 years. Conclusions: The incidence of PDPH was high in female and age group 18-30 years. The incidence of PDPH is high when the bevel is transverse to the dural fibers. Keywords: Bevel direction; incidence; post-dural puncture headache; spinal anesthesia   DOI: http://dx.doi.org/10.3126/joim.v32i2.4942 Journal of Institute of Medicine, August, 2010; 32: 30-32

scholarly journals Effect of Hydrocortisone on Reducing severity of Post Dural Puncture Headache after Spinal Anesthesia for Elective Caesarean Section

2018 ◽  
Vol 23 (4) ◽  
pp. 468-472
Author(s):  
Shumaila Ashfaq ◽  
Liaqat Ali ◽  
Muhammad Ashraf Zia ◽  
Rizwan Ahmad Khan ◽  
Mehtash Butt
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Conventional Treatment ◽  
Dural Puncture ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Post Dural Puncture Headache ◽  
Group A ◽  
Group B

Spinal anesthesia is frequently used in pregnant female undergoing caesarean section due to its safety than general anaesthesia. Post dural puncture headache (PDPH) is commonly occurring problem associated with spinal anaesthesia and causes a considerable morbidity. PDPH depends on several factor and various methods have been used to reduce and treat the pain of PDPH. We evaluated effects of hydrocortisone on the treatment of PDPH in obstetrical patient. To compare mean decrease in Visual Analogue Scalepain score in patients who developed PDPH after elective caesarean section under spinal anaesthesia who were given conventional treatment versus conventional treatment plus hydrocortisone. Double blind randomized control trial. Study conducted in department of anaesthesia and obstetrics of Allama Iqbal Medical College, Jinnah hospital (tertiary care) conducted from13th June 2014 to 13th December 2014. Sample size was calculated 60 (30 each) cases using 95% confidence interval, 80% power of test. Patients who developed PDPH after spinal anaesthesia for elective caesarean section were divided into 2 group; Group A (Conventional Treatment) and Group B, (Conventional Treatment plus Hydrocortisone 100mg 8 hourly for 48 hours). Details were recorded regarding age; mean pretreatment and post treatment VAS after 6 hours. Mean decrease in pain VAS score was 3.30 + 1.2 in group A while 7.17+ 1.3 in group B. (P value 0.001). Intravenous hydrocortisone is more effective in reducing post dural puncture headache pain severity after spinal anaesthesia for elective caesarean section when given along with conventional treatment as compared to conventional treatment alone.

A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 28-31
Author(s):  
Chetan Bohara ◽  
Rajesh Maharjan ◽  
Subi Regmi ◽  
Gunjan Regmi ◽  
Rajendra Kunwar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Sitting Position ◽  
Post Dural Puncture Headache ◽  
Subarachnoid Block ◽  
Group A ◽  
Group B

Introduction: Spinal anesthesia has offered a new armamentarium for the anesthesiologists and has been widely used in the Cesarean section in the field of obstetrics, an alternative to general anesthesia. However, Post Dural Puncture Headache remains an inevitable complication of spinal anesthesia and can be minimized its incidence by reducing the size of the needle and changing the design of the needle tip.  The objective of the study was to find the incidence of post-dural puncture headache undergoing subarachnoid block for CS using 25G Quincke and 25G Whitacre needles. Materials and methods: This study was conducted from August 2020 to January 2021 enrolling 72 parturients and were allocated in two groups of 36 each. Group A and B parturients received spinal anesthesia via. 25G Quincke and 25G Whitacre in sitting position respectively. All the patients were evaluated based on incidence, onset, duration, and severity of headache postoperatively for 72 hours after the subarachnoid block. Results: The incidence of post-dural puncture headache in the study was 7.2% in Group A and 3.15% in Group B which was statistically significant (P-value = 0.011), while there were no significant differences between these two groups in the onset, severity, and duration of post-dural puncture headache. Conclusion: Despite no significant differences were found for the onset, severity, and duration of post-dural puncture headache, the use of 25G Whitacre is associated with a reduced incidence of post-dural puncture headache compare to 25G Quincke.

scholarly journals The Sprotte Needle and Post Dural Puncture Headache following Caesarean Section

1993 ◽  
Vol 21 (3) ◽  
pp. 280-283 ◽  
Author(s):  
A. W. Ross ◽  
C. Greenhalgh ◽  
D. P. McGlade ◽  
I. G. Balson ◽  
S. C. Chester ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Population Size ◽  
Lower Incidence ◽  
Dural Puncture ◽  
Operating Conditions ◽  
Hyperbaric Bupivacaine ◽  
Post Dural Puncture Headache ◽  
The Difference ◽  
Obstetric Population

One hundred and forty-four patients receiving subarachnoid anaesthesia for caesarean section were prospectively analysed for quality of anaesthesia and the occurrence of post dural puncture headache (PDPH). Anaesthesia was administered via 24 gauge Sprotte (n = 104) and 26 gauge Quincke (n = 40) needles using hyperbaric bupivacaine 0.5% with morphine 0.2 mg. Anaesthesia was successful in 103 patients with the Sprotte needle and 38 patients with the Quincke needle, and the operating conditions were considered to be excellent. Of the 104 patients in the Sprotte needle group there were ten with PDPH (9.6%), two of which were considered severe. Of the 40 patients in the Quincke needle group there were eight with PDPH (20%), three of which were considered severe. Despite the lower incidence of headache in the Sprotte needle group, this was not statistically significant (P>0.05), due to the difference in population size. We conclude that the 24 gauge Sprotte needle is associated with a comparatively low but clinically relevant incidence of headache in the obstetric population.

scholarly journals Comparison of the effects of sagittal versus transvers 25-gauge quincke needle insertion on post-dural puncture headache development

2020 ◽  
Vol 7 (7) ◽  
pp. 554-559
Author(s):  
Mehmet Tercan ◽  
Tuğba Bingöl Tanrıverdi ◽  
Gülçin Patmano ◽  
Ahmet Atlas ◽  
Ahmet Kaya ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Dura Mater ◽  
Dural Puncture ◽  
Multivariate Logistic Regression Analysis ◽  
Needle Insertion ◽  
Spinal Needle ◽  
Post Dural Puncture Headache ◽  
Spinal Puncture ◽  
American Society

Objective: Post-dural puncture headache (PDPH) is one of the most important complications after spinal anesthesia. This study aimed to investigate the effect of the sagittal or transverse application of 25-gauge Quincke spinal needle on PDPH development in patients undergoing cesarean section. Material and Methods: A total of 295 patients with a planned cesarean section between the ages of 18-40 years with an American Society of Anesthesiologists score of 1 or 2 were included in the study. For the spinal intervention, 25-gauge Quincke spinal needle was used in all patients. Patients were included in one of two groups according to the spinal needle cutting direction of the dura mater fibers as sagittal (parallel to dura mater fibers, Group S; n=145) or transverse group (perpendicular to dura mater fibers, Group T; n=150). Results: PDPH developed in 27 (9.2%) patients. Patients in Group T had significant higher ratio of PDPH compared to patients in Group S (16% vs. 2.1%, p<0.001). Additionally, patients with PDPH had a significantly higher frequency of ≥2 spinal puncture attempts compared to patients without PDPH (22.2% vs. 4.5%, p=0.003). Multivariate logistic regression analysis demonstrated that transverse needle direction (OR: 11.40, 95% CI: 2.73-34.71; p<0.001) and ≥2 spinal puncture attempts (OR: 9.73, 95% CI: 3.13-41.55; p<0.001) and were independent predictors for PDPH development. Conclusion: Transverse insertion of the 25-gauge Quincke needle into spinal cord fibers and repeated interventions are independently associated with the development of PDPH in cesarean section patients undergoing spinal anesthesia

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