Factors that influence the appearance of dural post-puncture headache in patients undergoing elective cesarean section.

Abstract

An epidemiological, observational, analytical and retrospective study of cases and controls was conducted with women undergoing elective cesarean section under spinal anesthesia at the Carlos Manuel de Céspedes Hospital in Bayamo, Granma province, from February 2013 to December 2015; with the objective of identifying the risk factors hypothetically related to the appearance of postpuncture dural headache in obstetric patients undergoing elective cesarean section.All the patients who gave their consent to participate, their data collection form was prepared for the study that collected the variables of the study. In addition, with each hypothetically influencing factor, the estimate of the benefit frame (OR) and its 95% confidence intervals (95% CI) and the hypothesis test of Chi to Square were performed. The age less than 25 years, the history of previous headache, the diameter of the needle of 20 and 22G, the greater number of puncture attempts and the position of the seated patient are the risk factors related to the appearance of post-puncture headache dural, but not the body mass index higher than 30 in obstetric patients undergoing elective cesarean section.

Incidence and Factors Associated with Postspinal Headache in Obstetric Mothers Who Underwent Spinal Anesthesia from a Tertiary Hospital in Western Uganda: A Prospective Cohort Study

“…This study found that women who had 2, 3, and >3 puncture attempts were, respectively, 8, 28, and 20 times more likely to develop PSH as compared to those who had 1 attempt. This is consistent with a study done in Cuba [ 20 ] and the one done by Tarekegn et al [ 4 ] in Ethiopia. The number of puncture attempts is a reflection of the magnitude of damage that is caused, resulting in more sites from which CSF is lost; therefore, fewer attempts result in a lower incidence of PSH.…”

“…This study found that participants with prior chronic headache were 3 times more likely to develop PSH ( p =0.006), compared to those who reported no history of headache. This is consistent with the study done by Jabbari et al [ 13 ] in his review of articles and the one done by Frias Carrazana et al in Cuba [ 20 ]. The precise reason for this is unknown, but it is speculated that there could be some unique physiologic and neurologic transmitters that could explain the risk.…”

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

“…The effect of normal BMI, multiple attempts, and using needle size less than and equal to 22 gauge was in line with studies done in Japan [ 19 ], Ethiopia and Jordan [ 15 , 16 ] and, Cuba [ 20 ].…”

“…The pooled prevalence of PDPH in this meta-analysis was higher than studies done in Jordan by Khraise et al, 2017 with a prevalence of 6% [ 16 ], Nigeria by Mohammed et al, 2017 with a prevalence of 15.8% [ 18 ], Japan by Makito et al, 2020 with a prevalence of 1.16% [ 19 ] and turkey by Pirbudak et al, 2019 with a prevalence of 10.8% [ 22 ]. Our result is lower than studies done in Ethiopia by Tarekegn et al, 2017 with a prevalence of 42.6% [ 15 ], in Mulago by Nambooze et al, 2019 with a prevalence of 48.8% [ 17 ], in Cuba by Carrazana et al, 2018 with a prevalence of 33.3% [ 20 ] and in Turkey by Uluer et al, 2019 with a prevalence of 30% [ 21 ]. The discrepancy might be due to the variation in sociodemographic characteristics across studies, clinical setup differences, and study design.…”

“…The prevalence of PDPH among the included studies varied from 1.16% [ 19 ] to 48.8 [ 17 ]. Regarding study design, three studies [ 15 , 19 , 20 ] employed a cross-sectional design; four cohort studies [ [16] , [17] , [18] , 27 ] and two RCT studies [ 21 , 22 ]. Furthermore, concerning the study population, 7 studies [ [28] , [29] , [30] , [31] , [32] , [33] ] were conducted only on parturients [ [15] , [16] , [17] , [18] , 20 , 21 , 27 , 34 ] whereas the remaining two were done on all patients from whose we extracted data of cesarean section [ 19 , 22 ] ( Table 1 ).…”