Factors associated with post dural puncture headache among patients who underwent neuro axial anesthesia at FEU-NRMF Medical Center experience from January 2014 to December 2014 : a retrospective, cohort study / Jason A. Dacanay.

Includes appendices and bibliographical references.

Abstract: The main factors influencing the incidence of PDPH can be categorized as, characteristics of patient population; characteristics of needle used and puncture technique. The identification of patient related factors that can lead to higher incidence of PDPH during preoperative evaluation, the anesthesiologist skill and deeper understanding of PDPH is of great importance to minimize the morbidity of PDPH. This is a retrospective cohort study of 480 subjects that under went neuro axial anesthesia using Quincke gauge 23 and 25 for spinal anesthesia and Tuohy needle gauge 18 for epidural anesthesia from January 2014 to December 2014. Out of 480 subjects only 0.625% (n=3) experienced PDPH. Among those patients related factors included in this study that may influence the incidence of PDPH. Only BMI showed significant association with PDPH as proven by the p value of <0.001. Significant more proportion of subjects with BMI of 18.5 had PDPH with 2 (9.1%) while those with normal BMI only 1 (0.3%) had PDPH. Specifically, for Qincke gauge 23 and Tuohy gauge 18, BMI was significant associated with PDPH with p value 0.002 and <0.001 receptively. Greater than or equal to 3 attempts made using Quincke gauge 23 during spinal anesthesia, paramedian puncture technique and accidental dural puncture using epidural Tuohy needle gauge 18 were anesthesia related factors identified that showed significant association with PDPH with a p value of 0.005, 0.04 and <0.001 respectively. On the average, PDPH was developed after 52 hours.

Research - Department of Anesthesiology