Frequency and Risk Factor of Post-Dural Puncture Headache among Patients Underwent Cesarean Section under Spinal Anesthesia at a Tertiary Hospital in Somalia
Abdullahi Said Hashi, Özlem Deligöz, Mohammed AM Ahmed
Department of Anesthesiology and Reanimation, Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia
Giriş: Post-Dural Puncture Headache(PDPH) is one of the commonest complications of the neuraxial block associated with penetration of dura matter and continuous flow of cerebrospinal fluid[1]. This study aimed to assess the frequency and risk factors of PDPH in pregnant women undergoing C-section under spinal anesthesia in tertiary hospital in Somalia.
Gereç ve Yöntem: A hospital-based descriptive cross-sectional study was conducted; we sequentially recruited 270 pregnant women who underwent spinal anesthesia for C-section at a tertiary hospital, in Mogadishu, Somalia between April 2020 and February 2021. Data was collected by interviewing patients preoperatively and postoperative follow-up after twenty-four hours and on day 7 via phone headache by direct questioning about the classic signs, its onset, its severity and any associated symptoms. We used STATA version 16 for data analysis. Categorical variables were described as frequencies and percentages whereas numerical variables as mean or median appropriately. To evaluate the associations we used logistic regression analysis and P value <0.05 were considered statistically significant.
Bulgular: The overall prevalence of PDPH was 46.3% (n=125). 26-gauge sized spinal needle (Adjusted Odds ratio: 0.3, 95% CI: 0.12-0.74, p=0.009) was significantly less likely associated with PDPH compared to larger seized needles. More than a third of participants had PDPH after days 2 (n=48, 38.4%).
Tartışma ve Sonuç: We report high frequency of PDPH (46.3 %,) in our setting, compared to the acceptable range of 0.4%-25%. The size of the needle and the number of dural punctures were significantly associated with PDPH. To minimize the incidence of post dural puncture headache in our setting we should avoid use of big needles and repeated attempt especially on female patients.
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