Assessments of the Magnitude of Post Dural Puncture Headache (PDPH) and Associated Risk Facrors with Pdph Among Patients Undergoing Spinal Anesthesia for Orthopedics and Urologic Procedures in Black Lion Specialized Referral Hospital, Addis Abeba, Ethiopia
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Date
2016-06
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Addis Abeba University
Abstract
BACKGROUND: Although modern anesthesiology has made great progress in the last decades,
Neuraxial anesthesia (NA) is still the keynote of regional blockade. It is popular for its
effectiveness in producing anesthesia and analgesia with neuromuscular paralysis. As the NA
techniques are used popularly in clinic and Hospital, Post Dural Puncture Headache (PDPH), a
common iatrogenic complication resulted from post-spinal taps or accidental Dural puncture
subsequent to epidural block, is frequently reported and becomes a challenging to health
caregivers.
Although the problem has been widely reported verbally by the patients, its magnitude and
associated factors are not well being studied in our country. The aims of the study were to assess
the magnitude of Post Dural Puncture Headache (PDPH) and associated risk factors with PDPH
among patient who underwent spinal anesthesia for orthopedic and urologic procedures in Black
Lion Specialized Referral Hospital, Addis Ababa, Ethiopia. From February 15 to March 15, 2016
G.C
METHODS AND MAERIALS: An institutional based Cross Sectional study, was conducted
from February 15 to March 15, 2016 G.C in Black Lion Specialized Referral Hospital, Addis
Ababa Ethiopia. And a total of 76 consecutive patients undergoing SA aged 17–75 was participated
in the study. Those independent variable that were significant on binary logistic regression at P <
0.2, were analyzed on multivariate regression, and considered significant association with PDPH
at P value < 0.05.
RESULT: Out of 76 patients undergoing SA for orthopedic and Urologic Procedures; the
prevalence of PDPH was 33%. Among patients who develop PDPH; 54% of the patients reported
moderate pain while 44% experience mild PDPH. The number of spinal attempt was significantly
related (P-value .000, AOR 0.002; 95%CI; 0.000 - 0.03) to PDPH while sex, BMI and Age of the
patient was not found significantly related to PDPH with P-values of (0.618, 0.529 and 0.72)
respectively. CONCLUSION AND RECOMMENDATION: The incidences of Post Dural
Puncture Headache was found to be higher (33%) in Black Lion Hospital. The hospital
management and the anesthetists in the hospital should minimize the magnitude of PDPH by
avoiding use of big and traumatic needle (22G Q-needle) and repeated spinal attempt (> 2 attempt.
Key Words: Post Dural Puncture Headache, Spinal Anesthesia, Quincke Needle
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Keywords
Post Dural Puncture Headache; Spinal Anesthesia; Quincke Needle