Background: Post-Dural Puncture Headache is the commonest complication of spinal anesthesia. Body of evidence revealed that Conservative management failed to show significant benefit and epidural needle and catheter techniques didn’t provide conclusive evidence. On the other hand, intrathecal injection of normal saline is a simple technique and cost-effective in a resource-limited setup but it is not well examined on its effectiveness and safety profiles.Methods and materials: After Obtaining Ethical clearance from IRB, 152 mothers scheduled for cesarean section under spinal anesthesia were allocated randomly into two groups. Data analysis was done with SPSS version 22. Descriptive statistics were run to see the overall distribution of the study subjects. Unpaired student’s T-test for continuous symmetric data and Mann-Whitney U test for non-normally distributed data were used. Categorical data were analyzed with Chi-square and fisher’s exact test where appropriate. A generalized estimating equation model was used to investigate the interaction of repeated measurements of NRS pain scores of PDPH. Result: The overall incidence of PDPH was 29.6% while the proportion of patients who experienced PDPH was the highest among patients with control as compared to intervention( 36.8% vs 22%) respectively. The GEE model revealed that the NRS pain score was 0.7, 0.4, and 0.2 unit higher at 12, 24, and 48 respectively in control as compared to the interventionConclusion: prophylactic intrathecal normal saline could be an option in a resource-limited setup where the appropriate spinal needle is not accessible and management of moderate and severe PDPH is not feasibleRegistration: The protocol was registered prospectively in Clinical Trials.gov (NCT04393766).

Background: Post-Dural Puncture Headache is the commonest complication of spinal anesthesia. Body of evidence revealed that Conservative management failed to show significant benefit and epidural needle and catheter techniques didn’t provide conclusive evidence. On the other hand, intrathecal injection of normal saline is a simple technique and cost-effective in a resource-limited setup but it is not well examined on its effectiveness and safety profiles. Methods and materials: After Obtaining Ethical clearance from IRB, 152 mothers scheduled for cesarean section under spinal anesthesia were allocated randomly into two groups. Data analysis was done with SPSS version 22. Descriptive statistics were run to see the overall distribution of the study subjects. Unpaired student’s T-test for continuous symmetric data and Mann-Whitney U test for non-normally distributed data were used. Categorical data were analyzed with Chi-square and fisher’s exact test where appropriate. A generalized estimating equation model was used to investigate the interaction of repeated measurements of NRS pain scores of PDPH. Result: The overall incidence of PDPH was 29.6% while the proportion of patients who experienced PDPH was the highest among patients with control as compared to intervention( 36.8% vs 22%) respectively. The GEE model revealed that the NRS pain score was 0.7, 0.4, and 0.2 unit higher at 12, 24, and 48 respectively in control as compared to the intervention Conclusion: prophylactic intrathecal normal saline could be an option in a resource-limited setup where the appropriate spinal needle is not accessible and management of moderate and severe PDPH is not feasible Registration: The protocol was registered prospectively in Clinical Trials.gov (NCT04393766). Highlights

Background: preeclampsia is very challenging for anesthetists due to the heterogeneous clinical spectrum of the disease characterized by hypertension, risk of hypotension, high risk of aspiration, and difficult airway. Therefore, the Meta-Analysis is intended to provide evidence on maternal and neonatal outcomes of preeclamptic parturient. Methods: A comprehensive strategy was conducted in PubMed/Medline, Science Direct, and Cochrane from January 2000 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot and I2 test. Observational and experimental studies reporting maternal and neonatal outcomes among preeclamptic and normotensive women were included. Results: The Meta-Analysis revealed that pooled incidence of hypotension was reduced by thirty-eight percent in preeclamptic as compared to normotensive parturient, RR = 0.62(95% confidence interval (CI): 0.52 to 0.75). Conclusion: The Meta-Analysis revealed that the incidence of hypotension was lower in preeclamptic women when compared to normotensive women. The included studies were low to a very low quality of evidence which entails further randomized controlled trials. Registration: This systematic review and meta-analysis was registered in research Registry (UIN of reviewregistry1068).