Efficacy of prophylactic epidural saline for reducing postdural puncture headache in patients undergoing caesarean section

Abstract

Aim: Post-Dural Puncture Headache (PDPH) is a common complication of spinal anesthesia during the postoperative period. The optimal means of prevention, management, and treatment of this disorder are uncertain. The objective of this current study was to investigate the effect of a 24 hours-continuous infusion of saline on the occurrence of PDPH in patients undergoing caesarean section and to provide a reference for the clinical prevention of PDPH. Methods: This study included 126 patients aged between 18 and 45 years with an American Society of Anesthesiology physical status (ASA) score of 1-2, who underwent elective caesarean operation. Patients were randomized into control (n=63) and study groups (n=63). Spinal anesthesia was administered to both groups via a 27-gauche spinal needle. The study group was administered normal saline infusion for 24 hours with an easy-pump device through an epidural catheter. Results: Seven control-group patients developed PDPH within the first 72 hours postoperatively while it was not observed in any of the study-group patients. Visual analogue scale and numerical rating scales were used for pain measurement. Five patients described mild pain while two described moderate pain. Severe headache was not observed in any patients at any time. Conclusion: This study demonstrated that the administration of epidural saline during an elective caesarean under spinal anesthesia significantly reduced the incidence of PDPH and was not associated with any side-effects.