Abstract

Introduction: Postdural puncture headache is the most common complication after spinal anaesthesia. In about 85%, it resolves without any specific treatment but sometimes it leads to serious complications such as subdural haematoma and seizures, which could be fatal. Spinal anaesthesia is the most popular anaesthesia technique for Cesarean section. Emphasis on prevention and optimal treatment of postdural puncture headache is very important. This study is aimed to determine the incidence of postdural puncture headache following Cesarean section via spinal anaesthesia and evaluate the different methods of management so as to prevent the complications.


Materials and Methods: This is a cross sectional study done in post natal ward of Manipal Teaching Hospital conducted for six months. Total of 261 pregnant women who underwent Cesarean section under spinal anaesthesia were taken and were observed for symptoms of postdural puncture headache. Medications were prescribed for the treatment of the same. Data was collected and analysed using various statistical tools.


Result: Of the total 261 patients, there were 28 (10.8%) cases with postdural puncture headache. Patients were managed by both conservative and pharmacological methods. Commonly used analgesics were combination of paracetamol and ibuprofen in 6(35.3%) patients. Conservative management included bed rest, supine positioning, adequate hydration and intake of coffee.


Conclusion: It was observed that use of small gauze needle size (25G) significantly reduced the chance of postdural puncture headache. Commonly used analgesics like paracetamol and ibuprofen combination, diclofenac could cure the headache.

Keywords: Cesarean section, spinal anaesthesia, post dural puncture headache, lumbar puncture