Headache in post dural puncture using various sizes of spinal needles

Abstract

Post-Dural puncture headache (PDPH) is one of the most common complications encountered by physicians following spinal anesthesia or lumbar puncture. This study was done for evaluating the incidence of PDPH following spinal anesthesia in the south Indian population using various gauges of Quinckes spinal needle.

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

“…As early as 1956, the use of small-gauge needles showed a significant reduction in postspinal headache yet, recent studies still report high incidences [ 6 ]. The high incidences of postspinal headache are associated with young age [ 7 ], female gender, pregnancy, cutting spinal needle design [ 8 ], prior history of postspinal headache, needle orientation perpendicular to dural fibers [ 9 ], bigger size of the spinal needle [ 10 ], low patient's body mass index, greater number of puncture attempts, sitting position during anesthesia [ 11 ], greater amount of cerebrospinal fluid drops allowed to fall [ 12 ], prior history of spinal anesthesia, prior history of chronic headache [ 13 ], late time at the start of postoperative ambulation [ 5 ], level of puncture entry above L3-4 [ 13 ] and a loss of more than 500 ml of blood during surgery [ 5 ] among others, majority of which are modifiable. Postspinal headache is associated with significant morbidity and mortality and other socioeconomic consequences such as litigation, longer hospital stay, financial burden, reduced productivity, and interruption of maternal and neonatal bonding [ 13 , 14 ].…”