Factors that influence the appearance of dural post-puncture headache in patients undergoing elective cesarean section.

Graciela Maria Frias Carrazana,Yacnira Martínez Bazán,Secundino González Pardo,Bernardo Blanco-Zamora,Yurisnel Ortiz Sánchez,Sandra Blanco Martínez

doi:10.36648/2471-982x.5.1.25

Graciela Maria Frias Carrazana, Yacnira Martínez Bazán + Show 4 more

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https://doi.org/10.36648/2471-982x.5.1.25

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Abstract

An epidemiological, observational, analytical and retrospective study of cases and controls was conducted with women undergoing elective cesarean section under spinal anesthesia at the Carlos Manuel de Cespedes Hospital in Bayamo, Granma province, from February 2013 to December 2015; with the objective of identifying the risk factors hypothetically related to the appearance of postpuncture dural headache in obstetric patients undergoing elective cesarean section. All the patients who gave their consent to participate, their data collection form was prepared for the study that collected the variables of the study. In addition, with each hypothetically influencing factor, the estimate of the benefit frame (OR) and its 95% confidence intervals (95% CI) and the hypothesis test of Chi to Square were performed. The age less than 25 years, the history of previous headache, the diameter of the needle of 20 and 22G, the greater number of puncture attempts and the position of the seated patient are the risk factors related to the appearance of post-puncture headache dural, but not the body mass index higher than 30 in obstetric patients undergoing elective cesarean section.

Highlights

This article is available from: http://anaesthesia-painmedicine.imedpub.com/archive.php years of age in both groups being more frequent in the study: the group of cases, 78 patients (27.08%), while in controls, 98 patients (34.02%)
The number of patients with a body mass index greater than 30 prevailed in both groups, 49 patients (17.01%) in the group of cases and 97 patients (33.68%) in the controls, results that are shown in Table 1; when applying the Chi square test, with a 95% reliability, statistically insignificant results were obtained, and a weak association force was established between it and the occurrence of post-dural puncture headache (OR=1.02), what is not considered a risk factor in our study
The age under 25 years and the history of previous headache are the risk factors dependent on the patient related to the appearance of post-puncture headache in obstetric patients undergoing elective cesarean section

Summary

Introduction

Dr August Bier of the University of Berlin, was the first to perform a true spinal anesthesia in 1898, using a Quincke type needle and 10-15 mg of cocaine; as a consequence, the patient developed an intense headache after the operation [1]. It is defined as a scientific problem: What are the risk factors hypothetically related to the appearance of post-puncture dural. Observational, analytical and retrospective study of cases and controls was conducted with women undergoing elective cesarean section under spinal anesthesia at the Carlos Manuel de Céspedes Hospital in Bayamo, Granma province, in the period from February 2013 to December 2015. For the calculation of the size of the final sample, a study of unpaired cases and controls with a non-sick-diseased relationship was designed (2: 1)

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