Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

Basazinew Chekol Demilew; Aragaw Tesfaw; Alemitu Tefera; Bekalu Getnet; Keder Essa; Agazhe Aemero

doi:10.1177/20503121211051926

Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019

SAGE Open Med. 2021 Oct 13:9:20503121211051926. doi: 10.1177/20503121211051926. eCollection 2021.

Authors

Basazinew Chekol Demilew¹, Aragaw Tesfaw², Alemitu Tefera¹, Bekalu Getnet³, Keder Essa¹, Agazhe Aemero⁴

Affiliations

¹ Department of Anesthesia, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
² Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
³ Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
⁴ Department of Nursing, College of Medicine and Health Sciences, School of Nursing, University of Gondar, Gondar, Ethiopia.

Abstract

Introduction and objective: Postdural puncture headache is one of the most frequent late complications of spinal anesthesia. There are different factors that might predispose for postdural puncture headache. Therefore, the main aim of this study was to assess the incidence of postdural puncture headache and its associated factors for parturients who gave birth by cesarean section under spinal anesthesia.

Methods: Hospital-based longitudinal study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regression were used to measure the association of factors with the presence of postdural puncture headache. A p-value of ⩽0.05 was used to decide statistical significance for multivariable logistic regression.

Result: A total of 119 parturients were participated in this study. The incidence of postdural puncture headache was 20.2%. According to multivariable logistic regression, having previous spinal anesthesia (adjusted odds ratio = 7.028; 95% confidence interval = 2.377-20.781; p = 0.0001), using 20- and 22-gauge needle (adjusted odds ratio = 4.206; 95% confidence interval = 1.247-14.187; p = 0.021), and repeated attempt (adjusted odds ratio = 4.699; 95% confidence interval = 1.594-13.872; p = 0.05) had statistically significant association with postdural puncture headache.

Conclusion: Larger gauge needle size, repeated attempt, and previous spinal anesthesia might increase the incidence of postdural puncture headache.

Keywords: Spinal anesthesia; cesarean section; parturient; postdural puncture headache.