Incidence of post dural puncture headache following caesarean section under spinal anaesthesia at the Aga Khan University Hospital, Nairobi.
BACKGROUND
Post dural puncture headache can be a debilitating complication of subarachnoid anaesthesia for a new mother. Successful management of post dural puncture headache requires adherence to clear policies and protocols with close follow up of patients by an experienced obstetric anaesthetist.


OBJECTIVE
To examine the cumulative incidence and severity of post dural puncture headache in obstetric patients who consented for spinal anaesthesia for Caesarean section.


METHODS
Prospective cohort study.


METHODS
All women who underwent Caesarean sections under spinal anaesthesia and fulfilled the inclusion criteria.


METHODS
Aga Khan University Hospital, a teaching and referral hospital in Nairobi, Kenya.


RESULTS
The overall cumulative incidence of post dural puncture headache was found to be 20.35 % but was significantly higher in patients in whom the quincke type of needle was used than in those whose spinal anaesthetics were administered using the pencil point needle (24.2% and 4.5% respectively: p=0.042).


CONCLUSIONS
The incidence of post dural puncture headache can be significantly reduced in the obstetric population at the Aga Khan University Hospital if the pencil point spinal needle was to be routinely used. We recommend that the Quincke needles should not be used in the obstetric population at the Aga Khan University Hospital.
Department of Anaesthesia, Aga Khan University Hospital, Nairobi, P.O. Box 30270 - 00100, Nairobi, Kenya.
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Gisore
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Mung'ayi
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Sharif
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007630:Kenya; D051299:Post-Dural Puncture Headache / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult