PREVALENCE AND ASSOCIATED RISK FACTORS OF POST DURAL PUNCTURE HEADACHE IN CAESAREAN SECTION PATIENTS UNDER THE SPINAL ANESTHESIA

Abstract

Post Dural Puncture Headache (PDPH) is a common complication following spinal anesthesia, particularly among patients undergoing cesarean section. PDPH arises due to cerebrospinal fluid (CSF) leakage from the dural puncture site, leading to decreased intracranial pressure and positional headaches. It can significantly affect maternal recovery, prolong hospital stays, and impact maternal-neonatal bonding. The primary aim of this study was to determine the prevalence of PDPH among cesarean section patients receiving spinal anesthesia with a 27-gauge needle. Additionally, the study sought to identify patient-related and procedural risk factors associated with the development of PDPH.A descriptive cross-sectional study was conducted at a tertiary care hospital in Peshawar over a four-month period (April to August 2025). A total of 184 female patients aged 18– 45 years undergoing cesarean section under spinal anesthesia were included through non- probability sampling. Data were collected using a structured questionnaire and analyzed using SPSS version 26. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants. Out of 184 patients, 8 (4.34%) developed PDPH after receiving spinal anesthesia with a 27-gauge needle. The highest frequency of PDPH was observed among patients aged 39–46 years (5 cases), and those with a body weight between 76–83 kg (5 cases). Furthermore, 6 PDPH cases occurred in patients who received spinal anesthesia on the second attempt. No cases were reported among patients aged 18–25 years or weighing less than 69 kg. The data suggest that increasing age, higher body weight, and multiple puncture attempts are associated with an elevated risk of PDPH.