RESUMO
Spinal anaesthesia is the most common and widely practiced regional anaesthesia. It is used for various surgeries involving lower abdomen and lower limbs. However Spinal anesthesia also has some drawbacks and one of its well recognized complications is Post dural puncture headache [PDPH]
Aims and Objectives: the objective of this research was to identify different factors significantly influencing PDPH in over patient population
Material and Method: it was a single blinded, cross-sectional study carried out from January 2008 to December 2009, at the department of anesthesiology, Shaikh Zayed Hospital, Lahore. Patients admitted for any surgical procedure involving the region below the umbilicus and requiring spinal anesthesia for it, were included in our study. Every patient was given spinal anesthesia between L2-L3 or L3-L4 space, using the drug Bupivacaine [upto 2ml of 0.75% concentration] with the Quincke needle of a size 22G, 23G or 25G depending on the availability. All patients were blinded to the size of needle being utilized
Results: we studied 227 patients aged 17-90 years. Needle 22G was used on 52 patients [22.9%], 23G on 128 patients [56.4%] and 25G on 47 patients [20.7%]. Frequency of PDPH was 13/52 [25%] in patients receiving 22G needle, 14/128[11%] in 23G and 4/47[8%]in 25G.This relation was statistically significant with a P value of 0.024 .PDPH occurred in 11% of males and in 24% of females. P value for this difference was also significant [0.019]. All the other variables studied did not have a significant P value
Conclusion: PDPH is more common in females. 25-Gauge Quincke needle has definite advantage over 22-gauge and 23 -Gauge needles as far as frequency of PDPH is concerned. Level of expertise, duration of surgery , number of attempts and occurrence of a hypotensive episode have no significant effect on the frequency of PDPH