A THESIS REPORT SUBMITTED TO THE DEPARTMENT OF ANESTHESIA FOR PARTIAL FULFILLMENT OF REQUIREMENTS FOR THE MASTER’S DEGREE IN ADVANCED CLINICAL ANESTHESIA

Abstract

Abstract Introduction: Post-Dural puncture headache is a major complication of neuraxial anesthesia that can occur following spinal anesthesia and with inadvertent dural puncture during epidural anesthesia. It is, postural, and frontal and relieved when the patient is supine position and aggravate during standing, sitting, coughing. Objective: The objective of this study was to determine the incidence and associated factors of post Dural puncture headache after cesarean section under spinal anesthesia at University of Gondar Comprehensive and Specialized Hospital. Methods: An institution based cross sectional study was conducted from March 01 to May 29, 2019 at University of Gondar Comprehensive and Specialized Hospital, Ethiopia. A total of 384 willing patients were included in the study after obtaining ethical approval from college ethical committee. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) window version 20.Descriptive statistics, cross-tabs and binary logistic regression analysis were performed to identify the association between post dural puncture headache and independent variables. The strength of the association was presented using AOR with 95% confidence interval and p-value<0.05 was considered as statistically significant. Results: The incidence of post dural puncture headache was 31.3% (95% CI: 26.2, 36.2) with response rate of 92.5%.In this study body mass index, Size of spinal needle, number of attempt and educational status anesthetists were significantly associated with post dural puncture headache. Conclusion and recommendations: Based on the results of the current study non-obese patients, big spinal needles, repeated number of attempts and educational status of anesthetists were the independent associated risk factors for post dural puncture headache. We recommend that avoiding use of big spinal needles, avoiding repeated attempts and giving spinal anesthesia by qualified anesthetists’ could minimize the incidence of post dural headache.