Factors Predisposing to Postdural Puncture Headache after Spinal Anaesthesia among Elective Caesarean Section Patients at Thika Level 5 Hospital, Kenya

IF 0.1 4区医学 Q4 INFECTIOUS DISEASES

Southeast Asian Journal of Tropical Medicine and Public Health Pub Date : 2023-10-31 DOI:10.9734/ajmah/2023/v21i11937

Munavu Angelina Nduku, Onyuka Jackson, Mwangi Wambui

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引用次数: 0

Abstract

Background: Postdural puncture headache (PDPH) is a common complication following spinal anaesthesia for Caesarean section (CS). There is little data on the incidence and its predisposing factors in low-income countries. The study aimed to investigate the incidence and factors predisposing patients to PDPH after a dural puncture during a planned Caesarean section under spinal anaesthesia at Thika Level 5 Hospital, Kenya. Methods: A cross-sectional study design was used. Pregnant women scheduled for planned Caesarean sections under spinal anaesthesia at Thika Level 5 Hospital were randomly recruited. Data was collected during the fourth quarter of 2021. Patient factors (age, BMI, bed rest, and previous history of PDPH), healthcare provider factors (qualification, experience, and the number of dural punctures), and equipment factors (size, design, and spinal needle orientation) were evaluated to determine predisposing factors for PDPH. Sample size obtained by the use of Fisher’s formula, resulting in a sample size of 103. Results: We found the incidence of PDPH at Thika Level 5 Hospital to be 24.5%. Patient and equipment factors were found to be associated with PDPH. Among the patient factors, high BMI was found to be significant (p = 0.039) while among the equipment factors, traumatic needle tip design (p = 0.049) and the perpendicular orientation of needle bevel (p = 0.022) were found to be associated with PDPH. Conclusion and Recommendations: We conclude that PDPH is a common complication following spinal anaesthesia for Caesarean section, and the incidence (24.5%) is relatively high at Thika Level 5 Hospital. High BMI, traumatic cutting spinal needle tip design and perpendicular orientation of the needle bevel are predisposing factors. Further research is needed to determine the predisposing factors of PDPH at different levels of hospitals in Kiambu County, and understand the specific mechanisms and measures to minimize the incidence PDPH

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肯尼亚Thika 5级医院择期剖宫产患者脊髓麻醉后硬脊膜穿刺头痛的易感因素

背景:硬脊膜穿刺后头痛(PDPH)是剖宫产(CS)脊髓麻醉后常见的并发症。关于低收入国家发病率及其诱发因素的数据很少。该研究旨在调查肯尼亚Thika 5级医院脊髓麻醉下计划剖宫产术中硬脑膜穿刺后PDPH的发生率和易感因素。方法:采用横断面研究设计。在Thika 5级医院随机招募计划在脊髓麻醉下进行剖腹产的孕妇。数据收集于2021年第四季度。评估患者因素(年龄、BMI、卧床休息和既往PDPH史)、医疗保健提供者因素(资格、经验和硬脑膜穿刺次数)和设备因素(尺寸、设计和脊髓针朝向)，以确定PDPH的易感因素。利用费雪公式得到的样本量，得到的样本量为103。结果:在西卡5级医院，PDPH的发生率为24.5%。患者和设备因素被发现与PDPH有关。在患者因素中，高BMI具有显著性(p = 0.039)，而在器械因素中，创伤性针尖设计(p = 0.049)和针尖垂直方向(p = 0.022)与PDPH相关。结论与建议:PDPH是剖宫产脊髓麻醉后常见的并发症，在Thika 5级医院发生率较高(24.5%)。高BMI，创伤性脊髓针尖设计和针尖斜面垂直方向是诱发因素。需要进一步研究确定基安布县各级医院PDPH的易感因素，了解降低PDPH发生率的具体机制和措施

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来源期刊

Southeast Asian Journal of Tropical Medicine and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-INFECTIOUS DISEASES

CiteScore

0.40

自引率

0.00%

发文量

审稿时长

3-8 weeks

期刊介绍： The SEAMEO* Regional Tropical Medicine and Public Health Project was established in 1967 to help improve the health and standard of living of the peoples of Southeast Asia by pooling manpower resources of the participating SEAMEO member countries in a cooperative endeavor to develop and upgrade the research and training capabilities of the existing facilities in these countries. By promoting effective regional cooperation among the participating national centers, it is hoped to minimize waste in duplication of programs and activities. In 1992 the Project was renamed the SEAMEO Regional Tropical Medicine and Public Health Network.