Effect of Patient Position during Spinal Anesthesia on the Incidence of Post-Dural Puncture Headache after Cesarean Section

Abstract

Objective: To compare the frequency of PDPH following spinal anesthesia in the sitting position and in the left lateral decubitus position in parturient who underwent elective caesarean section.

Methodology: It was a quasi-experimental study carried out in a tertiary care hospital of Pakistan. A total of 120 parturient experiencing elective CS under spinal anesthesia were randomized to either the sitting or lateral position group. The primary outcome was the incidence of PDPH within 5 days of the procedure postoperatively. Secondary outcomes included the incidence of adverse effects for instance, hypotension, nausea/vomiting and bradycardia.

Results: The frequency of PDPH after the procedure was significantly higher among patients in sitting group than among patients in lateral group (33.3% vs. 6.7%). In sitting position group, 63.3% women had hypotension, 26.7% had bradycardia and 30.0% had nausea / vomiting while in lateral position group, 58.3% women had hypotension, 21.7% had bradycardia and 23.3% had nausea/vomiting

Conclusion: Study concluded that lateral position during spinal anesthesia for cesarean section is associated with a lower incidence of PDPH as compared to the sitting position.