Prevalence Of Post Dural Puncture Headache And Associated Factors In Mothers For Elective Cesarean Section At Muhimbili National Hospital

Abstract

Background Neuraxial anesthesia is still the key note of regional blockade; it is popular for its effectiveness in producing anesthesia and analgesia. Post dural puncture headache occurs as the cerebrospinal fluids leaks out from the breach that the needle has made in the dura during administration of spinal anesthesia. PDPH is a common complication after spinal anesthesia(1). However spinal anesthesia is one of the routinely done procedures in practice.

Broad objective To assess the magnitude of post dural puncture headache and associated factors after spinal anesthesia among patients at Muhimbili National Hospital.

Study Design Hospital based cross sectional study

Study Population All patients undergoing elective caesarean section under spinal anesthesia during the study period.

Study setting The study was conducted at MNH, Dar es Salaam at the maternity theater and maternity ward.

Data Collection A data collection form was used to collect data from all eligible patients included in the study period, who came for elective cesarean section under spinal anesthesia at MNH. Patients were interviewed and their chart reviewed at 24 hrs, 48hrs and 72 hrs, postoperatively by the principle investigator.

Data Analysis Data collected was coded, entered in computer and managed in Microsoft access database. It was analyzed using SPSS version 20 and presented in tables and graphs. All variables were categorized and described using frequency distribution. Bivariate association was described using chi- square test, a p –value of < 0.05 was considered statistically significant.

Results Out of 276 mothers undergoing spinal anesthesia for elective cesarean section the prevalence of PDPH was found to be higher 56% among patients who developed PDPH. Multiple dural puncture attempts were significantly related to PDPH (P value ≤ 0.001). While younger age is susceptible to developed PDPH. Out of the 154 mothers who developed PDPH, 124 had other symptoms associated with PDPH.

Conclusions and Recommendations The prevalence of PDPH was found to be higher in MNH. The hospital management and the anesthetists in the hospital should minimized the prevalence of PDPH by avoiding multiple dural puncture and encourage single attempt during training of residents