Effect of position on incidence of post-dural puncture headache in patients undergoing caesarean section: A comparative study

Abstract

Background: Postdural puncture headache (PDPH) is an expected complication after lumbar puncture (LP). Spinal anaesthesia (SA) is given to a patient in lateral decubitus or in the sitting position. Our aim is to compare the incidence of PDPH between sitting and lateral decubitus position among patients scheduled for LSCS. Methods: This is a kind of comparative study done on 200 pregnant women scheduled for elective lower segment caesarean section at our tertiary care centre named NRI Institute of Medical Sciences, Chinakakani Andhra Pradesh, India. Patients were randomized into two groups as per the position used for spinal anaesthesia. Group S(sitting) included 100 patients and group D (lateral decubitus) included 100 patients. Results: There is no significant difference in the mean age, mean BMI and ASA grade of patients in both groups. The incidence of post-dural puncture headache was more common in sitting group patients on a postoperative day 1 compared to lateral decubitus group patients. The intensity of headache was more in sitting group patients from days 1 to 3 postoperatively. There is no significant difference in postoperative nausea and vomiting between two groups. Conclusion: The incidence of post-dural puncture headache is more common among patients in the sitting group compared to patients kept in lateral decubitus position. Also, the intensity of headache is more in the sitting group among pregnant women who were scheduled for elective lower segment caesarean section.