Skip to content
Research Article Open access CC BY 4.0

Factors Predisposing to Postdural Puncture Headache after Spinal Anaesthesia among Elective Caesarean Section Patients at Thika Level 5 Hospital, Kenya

Munavu Angelina Nduku, Onyuka Jackson, Mwangi Wambui

Asian Journal of Medicine and Health · pp. 202–210 · Published 31 Oct 2023

10.9734/ajmah/2023/v21i11937

Abstract

Background: Postdural puncture headache (PDPH) is a common complication following spinal anaesthesia for Caesarean section (CS). There is little data on the incidence and its predisposing factors in low-income countries. The study aimed to investigate the incidence and factors predisposing patients to PDPH after a dural puncture during a planned Caesarean section under spinal anaesthesia at Thika Level 5 Hospital, Kenya. Methods: A cross-sectional study design was used. Pregnant women scheduled for planned Caesarean sections under spinal anaesthesia at Thika Level 5 Hospital were randomly recruited. Data was collected during the fourth quarter of 2021. Patient factors (age, BMI, bed rest, and previous history of PDPH), healthcare provider factors (qualification, experience, and the number of dural punctures), and equipment factors (size, design, and spinal needle orientation) were evaluated to determine predisposing factors for PDPH. Sample size obtained by the use of Fisher’s formula, resulting in a sample size of 103. Results: We found the incidence of PDPH at Thika Level 5 Hospital to be 24.5%. Patient and equipment factors were found to be associated with PDPH. Among the patient factors, high BMI was found to be significant (p = 0.039) while among the equipment factors, traumatic needle tip design (p = 0.049) and the perpendicular orientation of needle bevel (p = 0.022) were found to be associated with PDPH. Conclusion and Recommendations: We conclude that PDPH is a common complication following spinal anaesthesia for Caesarean section, and the incidence (24.5%) is relatively high at Thika Level 5 Hospital. High BMI, traumatic cutting spinal needle tip design and perpendicular orientation of the needle bevel are predisposing factors. Further research is needed to determine the predisposing factors of PDPH at different levels of hospitals in Kiambu County, and understand the specific mechanisms and measures to minimize the incidence PDPH

Caesarean section post-dural puncture headache subarachnoid space spinal anaesthesia

References (12)

  1. 1 The Relationship of Body Mass Index with the Incidence of Postdural Puncture Headache in Parturients [DOI]
  2. 2 Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors.
  3. 3 Incidence and risk factors of postdural puncture headache: prospective cohort study design [DOI]
  4. 4 Postdural puncture headache [DOI]
  5. 5 Incidence and clinical significance of post-dural puncture headache in young orthopaedic patients and parturients
  6. 6 An analysis of postdural puncture headache in obstetric patients: A study from Kano, Nigeria [DOI]
  7. 7 The Relationship of Body Mass Index With the Incidence of Postdural Puncture Headache in Parturients [DOI]
  8. 8 Effectiveness of ketofol versus propofol induction on hemodynamic profiles in adult elective surgical patients: A Randomized Controlled Trial [DOI]
  9. 9 A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia [DOI]
  10. 10 International Journal of General Medicine [DOI]
  11. 11 Posture and fluids for preventing post-dural puncture headache [DOI]
  12. 12 Incidence and risk factors of Postdural Puncture Headache: Prospective cohort study design [DOI]

Cited by 1

CROSSECTIONAL STUDY

Rizal Achmad Fadilah, Wilis Sukmaningtyas, Asmat Burhan

Related research

Article metrics

Real usage data collected on this platform.

67

Page views

0

PDF downloads

18

Outbound clicks

1

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.