Frequency of Post Dural Puncture Headache with Median Versus Para-Median Approach of Spinal Anaesthesia in Patients Underwent Cesarean Section

Abstract

Objective: To compare the frequency of post dural puncture headache with median versus para-median approach of spinal
anaesthesia in females undergoing cesarean section.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Anesthesiology and Obstetric departments, Combined Military Hospital, Badin Pakistan, from
Oct 2018 to Apr 2019.

Methodology: Total 128 females undergoing cesarean section, fulfilling the inclusion criteria were included randomly in two
equal groups. Group-A received spinal anaesthesia with 25 G Quincke spinal needle by median approach while Group-B
received by paramedian approach. Post-dural puncture headache was assessed by using visual analogue scale. Pain of any
severity was taken as positive. All patients were followed by researcher for presence or absence of post-dural puncture
headache.

Results: Post dural puncture headache occurred in 21(32.81%) patients with median approach versus 4(6.25%) patients
complained headache after para-median approach with p-value=0.0001, frequency was statistically significant.

Conclusion: This study concluded that more frequency of headache after dural puncture in median approach compared to
para-median approach in cesarean section patients.