Dataset Information

Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study.

ABSTRACT:

Background

Spinal anesthesia is the most commonly used anesthesia technique for Cesarean delivery with 80%-95% prevalence. The most common complication of SA is post-dural puncture Headache which is associated with dural puncture & Cerebrospinal fluid leak. This study aimed to assess the incidence and associated factors of post-dural puncture headache.

Methods

single-armed cohort study design was employed on 412 women from May 2021 to January 2022. Study subjects were selected using systematic random sampling. Descriptive statistics for each variable, binary logistic regression, and multiple logistic regression analysis with 95% CI was carried out.

Results

The overall incidence of post-dural puncture headache in this study was 25.7%. 43.9% of Post dural headache was detected in the 1st 24 h followed by 48 h. Of those who develop Post-dural headaches, 54.1% of them had mild pain, 17.3% of them was moderate pain and 28.6% of them suffered severe pain. The multivariable analysis indicated that BMI>30 kg/m² [AOR 2.85 95% CI: 1.91-4.25], number of attempts (>3), (AOR = 1.5, 95% CI: 1.19-1.91), and cephalic needle direction (AOR = 5.79 95% CI: 2.27-12.22), were factors associated with increased post-dural puncture headache. While large gauge needle size (AOR = 0.28 95% CI: 0.19-0.42), and greater than 3 years of experience of anesthetist (AOR = 0.44, 95% CI: 0.31-0.62) were associated with decreased incidence of post-dural puncture headache.

Conclusion

The incidence of post-dural puncture headache was higher in BMI>30 kg/m², greater than 3-time attempts during spinal anesthesia, using low gauge spinal needles, less than 3 years of experience as anesthetist and cephalic needle direction.

SUBMITTER: Girma T

PROVIDER: S-EPMC9121279 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study.

Girma Timsel T Mergia Getachew G Tadesse Muhiddin M Assen Sofia S

Annals of medicine and surgery (2012) 20220507

<h4>Background</h4>Spinal anesthesia is the most commonly used anesthesia technique for Cesarean delivery with 80%-95% prevalence. The most common complication of SA is post-dural puncture Headache which is associated with dural puncture & Cerebrospinal fluid leak. This study aimed to assess the incidence and associated factors of post-dural puncture headache.<h4>Methods</h4>single-armed cohort study design was employed on 412 women from May 2021 to January 2022. Study subjects were selected usi ...[more]

PMID: 35600186

Similar Datasets

Project description:Importance:Women giving birth have high rates of dural puncture secondary to neuraxial anesthesia and are at high risk for a resulting headache. It appears to be unknown whether there is a significant association between post-dural puncture headache and subsequent intracranial subdural hematoma. Objective:To determine the association of post-dural puncture headache with postpartum intracranial subdural hematoma. Design, Setting, and Participants:This cohort study of patients used hospital discharges recorded in the US Agency for Healthcare Research and Quality National Readmission Database for women who experienced childbirth from January 2010 to December 2016. Patients were included if they had been admitted for childbirth, had 2 months of follow-up data, and did not receive a diagnostic lumbar puncture. Only the first delivery for a calendar year was studied. Data were analyzed from January 2018 to June 2019. Exposures:Women with post-dural puncture headache associated with neuraxial anesthesia in the 2-month postpartum period were identified using International Classification of Disease (Ninth Edition and Tenth Edition) codes and were compared with those without post-dural puncture headaches. Main Outcome and Measures:The primary outcome was intracranial subdural hematoma in the 2-month postpartum period. Secondary outcomes included in-hospital mortality and occurrence of neurosurgery. Results:A total of 26?469?771 patients with 26?498?194 deliveries were included. Exclusion of repeated deliveries (n?=?28?423), deliveries without 2 months of follow-up data (n?=?4?329?621), and deliveries with diagnostic lumbar puncture (n?=?9334) resulted in a final cohort of 22?130?815 patients and deliveries. For the cohort, the mean (SD) age was 28.1 (6.0) years, and there were 68?374 post-dural puncture headaches, for an overall rate of 309 (95% CI, 302-316) per 100?000. There were 342 cases of subdural hematoma identified, indicating a rate of 1.5 (95% CI, 1.3-1.8) per 100?000 women. Of these, 100 cases were in women with post-dural puncture headache, indicating a rate of 147 (95% CI, 111-194) hematoma cases per 100?000 deliveries in this subgroup. Post-dural puncture headache had an unadjusted absolute risk increase of 145 (95% CI, 117-174) subdural hematoma cases per 100?000 deliveries. After adjusting for confounders, post-dural puncture headache had an odds ratio for subdural hematoma of 199 (95% CI, 126-317; P?<?.001) and an adjusted absolute risk increase of 130 (95% CI, 90-169; P?<?.001) per 100?000 deliveries. Conclusions and Relevance:The presence of presumed post-dural puncture headache after neuraxial anesthesia in childbirth, compared with no headache, was associated with a small but statistically significant absolute increase in the risk of being diagnosed with intracranial subdural hematoma. Further research is needed to establish if this association is causal for this rare outcome.

Project description:ImportanceDural-puncture epidural (DPE) and standard epidural are common modes of neuraxial labor analgesia. Little is known about conversion of DPE-initiated labor analgesia to surgical anesthesia for cesarean delivery.ObjectiveTo determine whether DPE provides a faster onset and better-quality block compared with the standard epidural technique for cesarean delivery.Design, setting, and participantsThis double-blind, randomized clinical trial was conducted between April 2019 and October 2022 at a tertiary care university hospital (University of Arkansas for Medical Sciences). Participants included women aged 18 years and older undergoing scheduled cesarean delivery with a singleton pregnancy.InterventionsParticipants were randomized to receive DPE or standard epidural in the labor and delivery room. A T10 sensory block was achieved and maintained using a low concentration of bupivacaine with fentanyl through the epidural catheter until the time of surgery. Epidural extension anesthesia was initiated in the operating room.Main outcomes and measuresThe primary outcome was the time taken from chloroprocaine administration to surgical anesthesia (T6 sensory block). The secondary outcome was the quality of epidural anesthesia, as defined by a composite of the following factors: (1) failure to achieve a T10 bilateral block preoperatively in the delivery room, (2) failure to achieve a surgical block at T6 within 15 minutes of chloroprocaine administration, (3) requirement for intraoperative analgesia, (4) repeat neuraxial procedure, and (5) conversion to general anesthesia.ResultsAmong 140 women (mean [SD] age, 30.1 [5.2] years), 70 were randomized to the DPE group, and 70 were randomized to the standard epidural group. The DPE group had a faster onset time to surgical anesthesia compared with the standard epidural group (median [IQR], 422 [290-546] seconds vs 655 [437-926] seconds; median [IQR] difference, 233 [104-369] seconds). The composite rates of lower quality anesthesia were 15.7% (11 of 70 women) in the DPE group and 36.3% (24 of 66 women) in the standard epidural group (odds ratio, 0.33; 95% CI, 0.14-0.74; P = .007).Conclusions and relevanceAnesthesia initiated following a DPE technique resulted in faster onset and improved block quality during epidural extension compared with initiation with a standard epidural technique. Further studies are needed to confirm these findings in the setting of intrapartum cesarean delivery.Trial registrationClinicalTrials.gov Identifier: NCT03915574.

Dataset Information

Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study.

Background

Methods

Results

Conclusion

Publications

Incidence and associated factors of post dural puncture headache in cesarean section done under spinal anesthesia 2021 institutional based prospective single-armed cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets