Correlation Between The Body Mass Index and Post-dural Puncture Headache in Parturients
Tolga Ergönenç1, Serbülent Gökhan Beyaz2, Aykut Sarıtaş3
1Department of Anesthesiology and Reanimation, Sakarya University Training and Research Hospital,Sakarya,Turkey
2Department of Anesthesiology and Pain Medicine,Sakarya University Faculty of Medicine,Sakarya,Turkey
3Department of Anesthesiology and Reanimation, Tepecik Training and Research Hospital,Izmir,Turkey
Background Post-dural puncture headache (PDPH) is seen more frequently in parturients due to stress, dehydration, intra-abdominal pressure, and insufficient fluid replacement after delivery. Obesity may protects against PDPH in parturients; increased intra-abdominal fat tissue reduced cerebrospinal fluid leakage by increasing the pressure in the epidural space. Therefore, this study investigated the correlation between the body mass index (BMI) on PDPH in elective caesarean section patients in whom 27G spinal needles were used. Methods The study included 420 women with American Society of Anesthesiology physical status I-II who underwent elective caesarean section under spinal anesthesia. The parturients with a BMI less than 30 were accepted as normal weight (Group I) and those with a BMI above 30 were accepted as obese (Group II). Dural puncture performed with a 27G Quincke spinal needle at the L3-4 or L4-5 intervertebral space and given 12.5 mg hyperbaric bupivacaine intrathecally. The patients were questioned regarding headache and low back pain 6, 12, 24, and 48 hours after the procedure, and by phone calls on days 3 and 7. Results PDPH developed in 34 (8.1%) patients. Of the patients who developed PDPH, 20 (58.8%) had a BMI < 30 and 14 (41.2%) had a BMI ≥ 30. Of the patients who did not develop PDPH, 232 (92.1%) had a BMI < 30 and 154 (91.7%) had a BMI ≥ 30. Conclusions This prospective study found the BMI values did not affect PDPH in elective caesarean section performed under spinal anesthesia.
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