IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 9, Issue 1 Ser. X. (Jan - Feb. 2020), PP 51-59 www.iosrjournals.org DOI: 10.9790/1959-0901105159 www.iosrjournals.org 51 | Page Effect of Nursing-Led Interventions on Post Dural Puncture Headache among Cesarean Section Women with Spinal Anesthesia HanaaElsayed Shahin 1 Amal Khalifa Khalil 2 ,Amr Abdellatief Mostafa 3 1&2 lecturer of Maternal and Newborn Health Nursing dept., Faculty of Nursing – Menoufia University Egypt 3 lecturer of anesthesiaMattaria Teaching Hospital-Egypt *Corresponding author: HanaaElsayedShahin , Abstract The most common method of anesthesia for cesarean section is spinal anesthesia.Postdural puncture headache (PDPH) is the most common complication in spinal anesthesia after caesarean section of these complications .The purpose: To assess the effect of nursing-led intervention onpostdural punctureheadache among caesarean section women with spinal anesthesia. ResearchDesign: a quasi-experimental Setting:Two setting in Menofyia University Hospital and Shebin Elkoom Teaching Hospital Subjects: A non-probable sample of 200 women. Instruments: Threeinstruments were used for datacollection. A structured interviewing questionnaire. The second was grading of PDPH severity. The third was a structured pre-and post-spinal anesthetic nursing intervention. Resultsthere were significant difference between the study and control group regarding incidence and frequency of postdural puncture headache after caesarean section with spinal anesthesia and the study group complain less headache from the second day (P 0.0001).Regarding the severity of PDPH in the control group there were 5 cases suffered from mild 17 case have moderate and 17 case have severe headache compared to study group were suffered from no sever pain and just seven have mild and 2 have moderate PDPH headache. The study group had no associated symptoms compared with the control group. Conclusion:The study hypothesis was accepted as Nursing-led intervention reduce incidence and associated symptoms of postdural puncture headache among cesarean section with spinal anesthesia. Recommendations: Generalize these nursing led interventions in hospitals to be included in the routine pre- operative and post-operative nursing care for mothers undergoing caesarean section with spinal anesthesia. Key words: Nursing-LedIntervention, Post dural Puncture Headache, Cesarean section, Spinal anesthesia --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 21-01-2020 Date of acceptance: 12-02-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Postdural puncture headache (PDPH) is one of the most recognized complications in women undergoing cesarean delivery, following spinal anesthesia. According to the International Tension Headache Society, the PDPH requirements include a tension headache that develops less than seven days after a spinal puncture, occurs or worsens less than fifteen minutes after assuming the upright position, and improves less than thirty minutes in the lying position with at least one of the following symptoms:neck stiffness, tinnitus, hypacusia, photophobia, and nausea. Post-Dural Puncture Headache is usually bifrontal and occipital, aggravated by movement of the head, upright posture and strain [1]. Nausea and vomiting are common symptoms that are preceded by PDPH, which can first occur several hours to days after the dural puncture. Recent publications have identified its incidences of around 15 % to 20 %. The symptoms generally improve slowly for time [2[. Dehydration, fasting, and probably related hypoglycemia, lack of caffeine intake, anxiety, and immobilization that contributes to muscle tension may contribute to PDPH [3]. The incidence of PDPH Increase with the presence of predisposing factors such as young age, past history, female sex, pregnancy, patient with low body mass index (BMI) and patient with high levels of stress during the procedure[3].A number of factors, including dehydration, hormonal imbalance and high serum oestrogen affecting the tone of the cerebral vessels, have involved the high incidence of PDPH in the obstetric population. In addition to operating factors such as needle size, needle tip shape, dural fiber bevel orientation, number of lumbar puncture attempts, midline versus lateral lumbar puncture approach type of local anesthetic solution, and clinical experience of the operator [4]. PDPH nursing led care consists of preoperative psychological support and abdominal binders, as well