Journal of Anesthesia & Critical Care: Open Access Assessment of the Prevalence and Associated Risk Factors of Post Dural Puncture Headache (PDPH) after Cesarean Section Delivery under Spinal Anesthesia Submit Manuscript | http://medcraveonline.com Abbreviations: PDPH: Post Dural Puncture Headache; SA: Spinal Anesthesia; CS: Cesarean Section Introduction Regional anesthesia is the favored methods of cesarean section delivery due to their safety to the mother, simplicity of the technique, lesser maternal risk and satisfactory postoperative analgesic effect [1-3]. However, Post-dural puncture headache (PDPH) has been a problem for patients next to dural puncture which is the iatrogenic cause of patient’s morbidity in modern anesthesia, as well as pain management therapy after attempted epidural and spinal blocks [2]. It is believed to be caused through penetration of dura matter by spinal needle with continuous cerebrospinal fluid (CSF) outflow. The concern of the new born and bond of family member may be affected by the post operative headache [4]. PDPH is explained as a bilateral headache which is associated with position. It is better during recumbence and worsened during upright position of the patient. The factors that can affect the incidence of PDPH includes age, gender, pregnancy, history of PDPH, shape of needle tip, size of needle, number of lumbar puncture and needle orientation to dural matter [4,5]. The association between needle size and type with incidence of PDPH was described as 75% for 16-18 G needles, 30% for 22 G Quinke needles and reduced to 0.37% for 27 G pencil point needles [6]. The most favourable needle sizes for spinal anesthesia are proba bly the 25G, 26G, and 27G needles [7,8]. When we used smaller size of spinal needle, there will be decreased risk of PDPH, due to low CSF leakage through narrowed puncture of the dura [8]. Based on the diagnostic criteria of the International Headache Society (IHS) in 2004, the Post dural puncture headache can appear up to the fifth day after the procedure and it is self limiting in a week which is defined by at least one of the following symptoms: neck stiffness, tinnitus, hypoacusia (partial loss of hearing), photophobia, and nausea are manifested [9]. In Ethiopia Bahir Dar, Felege Hiwot Referral Hospital anaesthetists are doing spinal anesthesia by spinal needles with different sizes, but the same design for Obstetric patients. We did this cross sectional study for the purpose of knowing the magnitude of PDPH based on this difference of needle sizes. Therefore, we assessed the prevalence and associated risk factors of PDPH after cesarean section delivery under spinal anesthesia Volume 8 Issue 6 - 2017 1 Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia 2 Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Ethiopia 3 Department of Anesthesia, College of Medicine and Health Science, Addis Ababa University, Ethiopia 4 Department of Anesthesia, College of Medicine and Health Science, Bahir Dar University, Ethiopia *Corresponding author: Fentahun Tarekegn, Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia, Tel: +251913824072; Email: Received: July 07, 2017 | Published: October 24, 2017 Research Article J Anesth Crit Care Open Access 2017, 8(6): 00330 Abstract Background: Post-Dural Puncture Headache (PDPH) is a common problem after a deliberate puncture of the dura-arachnoid for the purposes of diagnosis, therapy, spinal anesthesia, or unintentionally during epidural procedures. It is a clinically main complication which affects the daily life of patients with marked restriction of their physical activities. Spinal anesthesia is the frequent anesthetic procedure for obstetric patients which identified as cause for PDPH. The aim of the study was to assess the prevalence and associated risk factors of PDPH after Cesarean Section (CS) delivery under spinal anesthesia. Method:An institution based cross sectional study design was conducted on all eligible obstetric patients who came for operation under spinal anesthesia from September, 2015 to January,2016. The data collection method was including chart review and patient follow up for three days of post operative period. Results: 107/251 (42.6 %) patients developed PDPH. Among those patiens with PDPH big needle sizes (AOR=8.6; 95% CI: 0.06-0.46) and repeated number of attempts (AOR= 4.54; 95% CI: 0.52 –39.14), were found to be significantly associated with the dependent variable of PDPH on the multi variate logistic regression. Conclusion and recommendation: In this study, we showed the prevalence of PDPH was higher, 107/251 (42.6 %) compared with other literatures. The study also showed that big spinal needles and repeated number of attempts were the independent associated risk factors for PDPH in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. The higher magnitude of PDPH has to be reduced by avoiding use of big needles, and the repeated dura puncture. Keywords: Post dural puncture headache; Spinal anesthesia; Cesarean section; Spinal needle