Title: Comparison of Incidence of Post-Dural Puncture Headache (PDPH) in Patients Undergoing Lower Uterine Segment Caesarean Section (LSCS) among Different Batches of Residents

Authors: Dr Prajnyananda Das, Dr Bimal Krushna Panda, Dr Devi Prasad Mishra

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.155

Abstract

Introduction

Spinal anesthesia seems to be particularly well suited for caesarean section because of simplicity of procedure and rapid onset of dense block. However, post-dural puncture headache has remained a well-recognized complication. Post-dural puncture headache (PDPH) was first described by August Bier in 1898 and classically presents as a postural headache following therapeutic or diagnostic interventions of the epidural or spinal space1. The overall incidence of post-duralpucture headache varies from 0.1%-36%. It may be mild, moderate or severe and debilitating headache, and may be associated with neurological symptoms. 60% of PDPHs will begin within 2 days of having adural puncture, 90% within 3 days, though it may occur up to 14 days later2. Classically PDPH is a bilateral fronto-occipital headache, radiating to the neck and shoulders, exacerbated within 15 minutes of standing or sitting, is aggravated by coughing or straining and is alleviated within 30 minutes of recumbency, and further so by lying prone.3,4

References

  1. Turnbull DK, Shepherd DB. Post-dural puncture headache: Pathogenesis, prevention and treatment.Br J Anaesth. 2003;91(5):718–729. [PubMed]
  2. Reynolds F. Dural puncture and headache. BMJ. 1993;306(6882):874–876.
  3. Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Their role in postoperative outcome. Anesthesiology. 1995;82(6):1474–1506.
  4. Evans RW. Complications of lumbar puncture.NeurolClin. 1998;16(1):83–105
  5. Kuntz KM, Kokmen E, Stevens JC, Miller P, Offord KP, Ho MM. Post lumbar puncture headache: Experience in 501 consecutive procedure. Neurology. 1992;42:1884-7.
  6. International classification of headache disorders (1st ed.) International headache society.
  7. Denny N, Masters R, Pearson D, Read J, Sihota M, Selander D. Postduralpucture headache after continuous spinal anesthesia. Anesth Analg. 1987;66(8):791-4.
  8. Cesur M, Alici HA, Erdem AF, Silbir F, Celik M. Decreased incidence of headache after unintentionaldural puncture in patients with caesarean delivery administered with postoperative epidural analgesia.J Anesth. 2009;23(1):31-5.
  9. Mehjabeen F, Ghayarool H, Rahida H, Maryam A. Incidence of postduralpuncture headache in spinal anesPharm SciInnov 2014;3(2):154-7.

Corresponding Author

Dr Bimal Krushna Panda

Associate Professor, Department of Anaesthesiology, VIMSAR, Burla, India