Magnitude and associated factors of post Dural puncture headache after spinal anesthesia in surgical patients at comprehensive specialized referral hospital, 2021: A multi-center cross-sectional study

Abstract

BackgroundPost-Dural Puncture Headache (PDPH) is a common problem that happens after the Dura-arachnoid puncture during the procedure for diagnosis, therapy, and spinal anesthesia administration. This study aimed to assess the magnitude and associated factors of post-dural puncture headache (PDPH) after spinal anesthesia in surgical patients. MethodA multi-center institution-based cross-sectional study was conducted from September 1 to November 30, 2021, on 402 patients who came for an operation under spinal anesthesia. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) window version 26. Data were collected using a structured questionnaire. Descriptive statistics were expressed in percentages and presented with tables and figures. Both Bivariable and multivariable logistic analyses were done to identify the magnitude and associated factors of post-Dural puncture headache (PDPH) after spinal anesthesia in surgical patients. P < 0.05 with 95 % CI was set as statistical significance. ResultThe magnitude of post-Dural puncture headache (PDPH) after spinal anesthesia in surgical patients was 39.2[95 % CI = (34.7–44.1)]. Multivariable logistic analyses showed that being female [AOR = 3.5;95 %CI = (1.89,6.47)], patents who are nonsmokers [AOR = 2.3; 95 %CI = (1.23, 4.39)], cutting type of needle [AOR = 2.8;95 %CI = (1.39,5.68)] cephalic needle direction [AOR = 7.4;95 %CI = (3.95,14)] number of attempts more than two[AOR = 6.9; 95 %CI = (6.65,13.3)] were factors significantly associated with post-Dural puncture headache. ConclusionThe magnitude of post-Dura puncture headache (PDPH) after spinal anesthesia in surgical patients in this study was high. This study showed that a small spinal needle was much better than a large cutting spinal needle in the frequency of post-dural puncture headaches. In addition, the events were associated with frequent attempts during lumbar puncture and increased cerebrospinal fluid leakage. We recommend the use of a small spinal needle; to avoid more leakage of cerebrospinal fluid and multiple attempts at spinal anesthesia and lumbar puncture.