COMPARISON OF OCCURRENCE OF POST DURAL PUNCTURE HEADACHE IN LOWER SEGMENT CAESAREAN SECTION UNDER SUBARACHNOID BLOCK BY MEDIAN VS PARAMEDIAN APPROACH: A RANDOMIZED INTERVENTIONAL STUDY

Abstract

Aims: Spinal anaesthesia is a standard anesthetic technique in obstetrics, as it provides good analgesia and muscle relaxation. But every procedure comes with certain side effects and complications. Lumbar puncture for subarachnoid block is done by either median or paramedian approach. Besides postoperative headache, other side effects like nausea, vomiting have been reported in the postoperative period. Hereby we conducted a study on patients undergoing lower segment caesarean section (LSCS) under spinal anaesthesia by either median or paramedian approach, and compared the occurrence of post dural puncture headache in both groups. Methods and Material: 400 parturients of ASA grade I & II who underwent LSCS under spinal anaesthesia were divided into two groups: Group M (n=200) received spinal block by median approach while Group PM (n=200) received by paramedian approach. We observed the difference in proportion of cases who develop post dural puncture headache (PDPH) in both study groups and also to determine the difference in mean time duration of development of PDPH in both groups. Statistical analysis used:The data was analysed by using chi-square and T-test where p<0.05 was considered as statistically significant Results: 5 patients (2.5%) in group M developed PDPH whereas only 1 patient(0.5%) in group PM developed PDPH which was statistically non-significant (p=0.099). The mean time duration of onset of PDPH was similar in both groups. Conclusions:Hence from our observations we conclude that there is no statistically significant difference in the incidence of occurrence of PDPH when lumbar puncture is done with 25 G by either median or paramedian approach.