Postdural puncture headache: Incidence and predisposing factors in a university hospital

Abstract

Objectives: Postdural puncture headache (PDPH) may occur 12-72 hours after spinal anesthesia. PDPH causes patient discomfort following spinal anesthesia and therefore it presents a challenging situation for anesthetists. Methods: This prospective randomized study enrolled 613 patients who were 18 years or older and who had been operated under spinal anesthesia. The spinal anesthesia procedure was performed with the patient in a sitting position through the L3-4, L4-5 interspaces, using 25 and 26 gauge (G) quincke and pencil-point spinal needles. The gender, age, body mass index, level of sensory block, mobilization time of the patients and also the experience and physical fatigue condition of the physicians were recorded. In the postoperative period all patients were questioned as to whether they experienced headache. These questions were repeated at postoperative 1st, 24th, 48th and 72nd hours in the hospital and on the 7th day by phone after they were discharged. Results: Compared to older patients, patients between the ages of 25 to 40 (p<0.001) and compared to other operations, C/S patients (p: 0.003) experienced headaches more frequently in the postoperative period. The other two important factors were the experience (p: 0.013) and the physical fatigue of the physician (p: 0.001) on the day of surgery. Conclusion: The experience and good physical condition of the physician, TUR or anorectal surgery, a patient over 40 years of age and using pencil-point spinal needles during the spinal anesthesia procedure were associated with a reduced risk of postdural puncture headache.