title: [Headache following dural puncture in pregnant patients at term. Comparative study with non-obstetric patients].
abstract: OBJECTIVE
  To compare the incidence of postdural puncture headache after subarachnoid anesthesia with a 24G Sprotte needle among full-term obstetric patients as compared to non-obstetric patients.
  
  
  METHODS
  A total of 200 patients were studied prospectively, divided into 2 groups. Group 1 (n = 100) patients were delivered by cesarean section and group 2 (n = 100) patients underwent infraumbilical or traumatological surgery. All were ASA I-II and under 40 years of age. Hydration was accomplished with lactated Ringer's solution 400-1,000 ml before mid-line puncture. The anesthetic used in both groups was isobaric bupivacaine 0.5% with a vasoconstrictor. The incidence of arterial hypotension and accompanying symptoms was recorded; perioperative administration of vasoactive amines and anticholinergics and liquids administered was measured. Twenty-four to 48 hours later the patients were asked when they started walking and if postdural puncture headache was experienced.
  
  
  RESULTS
  Group 1 received smaller doses of bupivacaine (p < 0.05) and the incidence of arterial hypotension was greater (p < 0.01) and required increased administration of amines (p < 0.01) and perioperative fluid therapy (p < 0.001). No difference was found between the two groups either for time of start of ambulation or for incidence of headache, which was 1% in both groups.
  
  
  CONCLUSIONS
  The incidence of postdural puncture headache in obstetric patients is low and similar to that of non-obstetric patients when the 24G Sprotte needle is used.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de Valme, Sevilla.
authors.forename: M
authors.initials: M
authors.lastname: Echevarría
authors.forename: F
authors.initials: F
authors.lastname: Caba
authors.forename: L
authors.initials: L
authors.lastname: Olmedo
authors.forename: A
authors.initials: A
authors.lastname: Cruz
authors.forename: J M
authors.initials: JM
authors.lastname: Llamas
authors.forename: R
authors.initials: R
authors.lastname: Rodríguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000295:instrumentation; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000295:instrumentation; D002585:Cesarean Section; D004388:Dura Mater / Q000293:injuries*; D005260:Female; D005440:Fluid Therapy; D006261:Headache / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000150:complications / Q000517:prevention & control; D015994:Incidence; D011247:Pregnancy; D011446:Prospective Studies; D013346:Subarachnoid Space
vernacular_title: Cefalea pospunción dural en gestantes a término. Estudio comparativo con pacientes no obstétricas.