Comparison of the effect of paramedian and median methods on postdural puncture headache among candidates for elective ce- sarean sections undergoing spinal anesthesia. A double blind clinical trial

Abstract

Introduction Spinal anesthesia is the most common method used to re- duce pain throughout the birthing process. Post-dural puncture headache (PDPH) is the most common compli- cation of neuraxial anesthesia. This study was aimed to compare the effect of median and paramedian methods on the incidence of PDPH in cesarean section. Materials and Methods This double-blind clinical trial was performed on 140 pa- tients undergoing cesarean section referred to an educa- tional center in Urmia from March 1, 2020 to March 1, 2021. Data were collected through a demographic profile checklist and the visual analogue scale (VAS) tool. Results The mean ± SD of patients’ age was 27.81 ± 5.92 years. There was no significant difference between median and paramedian groups in terms of age (P = 0.079). Seven pa- tients from each group had PDPH, and according to VAS tool, the mean headache severity was 4.14 and 4 in the median and paramedian groups, respectively. There was no significant difference between the two groups in terms of incidence and severity of PDPH (P = 0.76 and P = 1, respectively). Patients with PDPH were significantly younger (P<0.001). Thirteen of the fourteen patients with PDPH aged 18 to 25 years, which was significantly higher than other groups (P<0.001). Conclusion The results of the present study showed that the type of spinal anesthesia, i.e., median and paramedian, has no ef- fect on the incidence and severity of PDPH. However, young age can be considered as a risk factor for PDPH.

Keywords

• post dural puncture headache
• pdph
• cesarean section
• spinal anesthesia