Headache Incidence Beyond Spinal Anesthesia of Caesarean Section View PDF
Suha Kadhim Jameel Al-Zubaidi
Medicine, Kidney Diseases And Transplantation Center, Al-Sadder Teaching Hospital, Iraq
Published on: 2024-09-16
Abstract
Background: A caesarean section (CS) is the delivery of a fetus through an abdominal incision and hysterotomy. The anesthesia method most often used for CS is spinal anesthesia (SA), the prevailing complication of SA is post-dural puncture headache (PDPH).
Aims of the study: To investigate the incidence of headache in SA in CS.
Methods: The study was conducted at Al-Sadder Teaching Hospital from the 1st of March 2023 till the 1st of March 2024. All women who attended the operation room for lower segment elective CS. Data were collected including age, educational level, job, parity, chronic diseases, past surgical and medical history. Then pre-operation assessment was done, including routine investigations, procedure explanation, and taking written informed consent.
Results: Totally 250 pregnant women who were subjected to a CS under SA. There was no statistical difference between the studied women regarding their socio-demographic characters. No statistical differences in clinical characters while the duration of anesthesia was prolonged (p = 0.01). There is no statistical difference in regard to headache at recovery time, 24 h, 48 h and a week postoperatively. However, 22% of women not complained.
Conclusion: There is no statistical difference between the studied women regarding their socio-demographic characters, and no statistical differences in clinical characters while the duration of anesthesia was prolonged. Headache postoperative at recovery time, 24 h, 48 h and a week is the same.
Keywords
Anesthesia, Spinal anesthesia, Caesarean section, Post-dural puncture headache, Pregnancy
Introduction
CS is fetus delivery via an abdominal incision and a uterine incision (hysterotomy) [1]. The rates of CS range from 4% to 44% [2, 3]. In Iraq, higher rate was recorded as 45 - 60%, because of greatest percentage of women below 20 years underwent CS, low education, poorly wealth quintiles, and rural women [4]. With the improvement of anesthetic techniques, CS has become safer and more secure over time, but maternal and fetal mortality and morbidity are still significant [5].
Regional anesthesia, as SA, it is the best option for elective uncomplicated CS due to the airway avoidance, low risk of aspiration of gastric content and ease of administration [6], it is a safe and effective method, it is associated with complications such as hypotension, local anesthetic toxicity, PDPH, and nerve injury [7]. There were various methods to prevent and treat PDPH, including bed rest, good hydration, non-opioid analgesics, caffeine, codeine, and corticosteroids [8]. Several pharmacological therapies, including aminophylline, gabapentin/ pregabalin, hydrocortisone, magnesium, ondansetron, dexamethasone and propofol, have been used for the prevention of PDPH in pregnancy [9].
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