Influence of Season on the Incidence of Postdural Puncture Headache- A Clinical Audit
S Parthasarathy, TS Shanthi
1. Professor, Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidypeeth, Kumbakonam, Tamil Nadu, India.
2. Consultant Obstetrician, Department of Obstetrics and Gynaecology, KRG Nursing Home, Kumbakonam, Tamil Nadu, India.
Correspondence Address :
Dr. S Parthasarathy,
20, Palanisamy Nagar, Chennai Salai, Kumbakonam, Tamil Nadu, India.
E-mail: painfreepartha@gmail.com
Abstract
Introduction: Postdural Puncture Headache (PDPH), even though becoming uncommon, is still one of the distressing postoperative complications after spinal anaesthesia. The reports on the incidence of PDPH are inconsistent, being 2-40% with different sizes of needles. A previous study conducted by the authors in the winter months in non obstetric cases, found a low incidence of PDPH and authors had suggested that there is a need to examine the association between PDPH and different seasons.
Aim: To find out the incidence of PDPH in obstetric population and any finding for differential incidence with different seasons.
Materials and Methods: The present study was a single centre retrospective clinical audit of lower segment caesarean cases (N=782) under spinal anaesthesia with 25-gauge Quincke needle. The records of summer and winter months were separated as two groups for each year of 2019 and 2020. The cases done in the months of March, April and May formed the summer group, while the October, November and December patients formed the winter group.
Results: There was no significant difference between the groups with regard to age (p-value=0.5). The incidence of PDPH was significantly higher in summer months than winter months in two consecutive years (p-value=0.0068). Fourteen out of 390 patients in the summer group and one out of 392 patients of the winter group suffered from PDPH overall.
Conclusion: There should be an urgent need to control ambient temperature in patients at risk of PDPH. The optimisation of coincident dehydration is essential.
Keywords
Dural puncture, Lower segment caesarean, Spinal anaesthesia
DOI and Others
DOI: 10.7860/JCDR/2022/52223.15946
Date of Submission: Sep 02, 2021
Date of Peer Review: Nov 13, 2021
Date of Acceptance: Dec 16, 2021
Date of Publishing: Feb 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin