Comparison of Post Dural Puncture Headache Among Patients Administrated Spinal Anesthesia with 25 Gauge and 27 Gauge Needles Undergoing Elective Cesarean Section

Syeda Amna Tahir; Fakhra Fakhr; Raja Azhar Mahmood; Wajeeh Ur Rehman

doi:10.51253/pafmj.v74iSUPPL-2.10697

Authors

Syeda Amna Tahir Shalamar Institute of Health Sciences, Lahore Pakistan, *Shalamar Hospital, Lahore, Pakistan
Fakhra Fakhr Shalamar Institute of Health Sciences, Lahore Pakistan, *Shalamar Hospital, Lahore, Pakistan
Raja Azhar Mahmood Shalamar Institute of Health Sciences, Lahore Pakistan, *Shalamar Hospital, Lahore, Pakistan
Wajeeh Ur Rehman Shalamar Institute of Health Sciences, Lahore Pakistan, *Shalamar Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74iSUPPL-2.10697

Keywords:

Cesarian Section, Paresthesia, Post Dural Puncture Headache Sagittal Sinus Thrombosis, Spinal anesthesia, Sub Dural Hematoma.

Abstract

Objective: To compare the outcome of 25 Gauge and 27 Gauge needles in terms of Post Dural Puncture Headache in patients undergoing spinal anesthesia at Gynae Surgical Wards.

Study Design: Quasi experimental study.

Place and Duration of Study: The study was conducted at the Gynae Surgical Wards of the Shalamar Hospital in Lahore, Pakistan from Sep 2022 to Apr 2023.

Methodology: 58 patients who met the study's inclusion requirements were recruited through non-probability, convenient sampling. They were split into two groups 29 patients in Group-A and 59 patients in Group-B. After obtaining informed consent, patients in Group-A received spinal anesthesia with a 25-gauge needle, whereas Group-B received spinal anesthesia with a 27-gauge needle. The data was collected using Proforma. At 24, 48, and 72 hours following the procedure, Post Dural Puncture Headache was assessed and data was analyzed using SPSS.

Results: The mean age of the subjects in Group-A was 26.21±3.016 years and the mean age of subjects in Group-B was 25.07±3.722 years. 21 patients out of 29 in Group-A (72.4%) developed PDPH. While only 9 Patients out of 29(31%) developed PDPH in Group-B. There is an association between needle gauge and headache (p-value 0.002).

Conclusion: The use of a 27G needle for administering spinal anesthesia should be preferred over a 25G needle, as the frequency of PDPH was found to be lower with the former.

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References

Sung T-Y, Jee YS, You H-J, Cho C-K. Comparison of the effect of general and spinal anesthesia for elective cesarean section on maternal and fetal outcomes: a retrospective cohort study. Anesthesia and Pain Medicine 2021; 16(1): 49-55.

Shitemaw T, Jemal B, Mamo T, Akalu L. Incidence and associated factors for hypotension after spinal anesthesia during cesarean section at Gandhi Memorial Hospital Addis Ababa, Ethiopia. PloS one 2020; 15(8): e0236755.

Pirenne V, Dewinter G, Van de Velde M. Spinal Anesthesia in Obstetrics. Best Practice & Research Clinical Anaesthesiology. 2023.

Lee SI, Sandhu S, Djulbegovic B, Mhaskar RS. Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis. Journal of Evidence‐Based Medicine. 2018; 11(3): 136-144.

Demilew BC, Tesfaw A, Tefera A, Getnet B, Essa K, Aemro A, et al. Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019. SAGE open medicine 2021; 9: 20503121211051926.

Patel R, Urits I, Orhurhu V, Orhurhu MS, Peck J, Ohuabunwa E, et al. A comprehensive update on the treatment and management of postdural puncture headache. Current pain and headache reports 2020; 24: 1-9.

Chekol B, Yetneberk T, Teshome D. Prevalence and associated factors of post dural puncture headache among parturients who underwent cesarean section with spinal anesthesia: A systemic review and meta-analysis, 2021. Annals of Medicine and Surgery 2021; 66: 102456.

Mandal AP, Gyani P, Kumar S, Kumar R. Comparative Evaluation of Different Needle Gauge of Needle for Spinal Anesthesia in Cesarean Section for Post-Operative Complication. Academia Anesthesiologica International 2019; 4(2).

Rahman MA, Alam AM, Mandal MA, Kamruzzaman M, Kabir MA, Begum SA, et al. Incidence of Postdural Puncture Headache after Caesarean Section Comparison Between 25G and 27G Quincke Variety of Spinal Needle. KYAMC Journal. 2017; 7(2): 762-769.

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. Journal of the American Academy of Orthopaedic Surgeons Global research & reviews 2018; 2(3).

Girma T, Mergia G, Tadesse M, Assen S. Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study. Annals of Medicine and Surgery 2022; 78: 103729.

Li H, Wang Y, Oprea AD, Li J. Postdural Puncture Headache—Risks and Current Treatment. Current Pain and Headache Reports 2022; 26(6): 441-452.

Jin Z, Ding O, Islam A, Li R, Lin J. Comparison of liposomal bupivacaine and conventional local anesthetic agents in regional anesthesia: a systematic review. Anesthesia & Analgesia 2021; 132(6): 1626-1634.

Ferede YA, Nigatu YA, Agegnehu AF, Mustofa SY. Incidence and associated factors of post dural puncture headache after cesarean section delivery under spinal anesthesia in University of Gondar Comprehensive Specialized Hospital, 2019, cross sectional study. International Journal of Surgery Open. 2021; 33: 100348.

Kwak K-H. Postdural puncture headache. Korean journal of anesthesiology 2017; 70(2): 136-143.

Vallejo MC, Zakowski MI. Post-dural puncture headache diagnosis and management. Best Practice & Research Clinical Anaesthesiology 2022; 36(1): 179-189.