Method of Management, Complications and Patient Satisfaction Among Obstetrics and Non-Obstetrics Patients Having Post Dural Puncture Headache (Pdph) After Undergoing Surgeries Under Subarachnoid Block in a Tertiary Care Hospital
Background: The present observational study was carried out to evaluate the method of Management, Complications and Patient satisfaction among obstetrics and non-obstetrics patients having Post Dural Puncture Headache (PDPH) after undergoing surgeries under subarachnoid block in a Tertiary Care Hospital. Material and Methods: This was a observational Prospective study carried out at Department of Anaesthesia, Dr Rajendra Prasad Medical College, Tanda conducted on consecutive patients ASA I and II, aged 20-60 years, obstetric/ non obstetric patients scheduled for surgery under subarachnoid block, over a period of 18 months including data collection, data organization, presentation, analysis and interpretation. After recruitment, the patients were divided into two groups comprising of obstetric and non-obstetric group. Results: The total patients included were 302, being 115 in obstetric group and 187 in non-obstetric group. In our study, out of 302 patients only 17 patients had post dural puncture headache, the total incidence being 5.6%.There were eight (7%) patients in obstetric and nine (4.8%) patients in non-obstetric group. All patients with PDPH had resolution of their symptoms by conservative management (hydration, bed rest, acetaminophen and NSAIDS), the PDPH resolved in 2(25%) of the parturients within the 1st day of its commencement, 5 (62.5%)parturients and 4 patients (44.4%) in non obstetric group had relief 2nd day after commencement of the headache. Whereas, one parturient(12.5%) and 4 patients(44.4%) in non obstetric group got relief on the 3rd day. One patient in non obstetric group (11.1%) had relief on the fourth day. 29% of the patient responded to the fluid and bed rest, whereas 35.2% patients required acetaminophen tablet as well, however 35.2% patients required the non steroidal anti-inflammatory drugs as well. No patient in either group required epidural blood patch. In obstetrics and non-obstetrics population, incidence of nausea and vomiting was in 8.7% and 7.5% patients respectively.Other complications like backache, vertigo were 2.61% and 2.7% patients in obstetric and non-obstetric population respectively. In obstetrics and non-obstetrics population, patient satisfaction was comparable (P=0.0778). Conclusion: All patients with PDPH had resolution of their symptoms by conservative management (hydration, bed rest, acetaminophen and NSAIDS) within 3-4 days while incidence of nausea and vomiting and other complications like backache, vertigo were very less.