POST-DURAL PUNCTURE HEADACHE AND RISK FACTORS IN WOMEN UNDERGOING CESAREAN SECTION WITH SPINAL ANESTHESIA
Objective: To estimate the incidence of post-dural puncture headache (PDPH) and risk factors in women underwent Cesarean section with spinal anesthesia. Materials and method: In a prospective descriptive study, parturients underwent Cesarean section with spinal anesthesia. Incidence of post-dural puncture headache, the history of spinal anesthesia and PDPH, presence of headache, preeclampsia, migraine, sinusitis, caffeine withdraw, insertion site, repeated puncture attempts, direction of the needle, size of the needle, local anesthesic, perioperative hypotension, nausea and vomiting, amount of intravenous fluid were recorded. Results: There were 389 patients in the study. The incidence of PDPH was 14.65% (mild and moderate pain: 75.44%; severe pain 21.05%; worst pain: 3.51%). The risk factors were history of PDPH (OR = 4.5; 95% CI: 1.8 - 11.09), sinusitis (OR = 2.65; 95% CI: 1.10 - 6.36), local anesthesia (Marcain spinal 0.5% heavy) (OR = 6.66; 95% CI: 2.25 - 19.11), perioperative hypotension (OR = 2.42; 95% CI: 1.25 - 4.70). Conclusion: The incident of PDPH in women undergoing Cesarean section with spinal anesthesia was 14.65%. Four risk factors were the history of PDPH, sinusitis, local anesthesia (Marcain spinal 0.5% heavy) and perioperative hypotension. Key words: post-dural puncture headache (PDPH), Cesarean section, spinal anesthesia