Frequency of post-dural puncture headache with median versus para-median approach in females who underwent cesarean section under spinal anaesthesia.

Abstract

Objective: To evaluate the frequency of post-dural puncture headache (PDPH) using the median versus paramedian approaches. Study Design: Prospective Comparative study. Setting: Department of Anesthesiology, Combined Military Hospital Bahawalpur. Period: 5^th August 2024 to 4^th February 2025. Methods: A total of 128 women who underwent spinal anesthesia for cesarean section between 16-40 years of age were included in study. Group M (Median Approach) women were undergone spinal anesthesia by median approach while Group P (Para-Median Approach) were undergone spinal anesthesia by para-median approach. All patients were assessed for development of post-dural puncture headache. Results: Mean ages were comparable between Group M (28.09 ± 5.52 years) and Group P (27.77 ± 5.88 years). The majority of subjects, 64.84% (n=83), were aged 16–30 years. Mean gestational age was 38.57 ± 1.31 weeks with a mean parity of 3.07 ± 1.07. Post-dural puncture headache occurred in 21 women (32.81%) following the median approach, versus only 4 women (6.25%) following the paramedian approach. Conclusion: This study concluded that the paramedian approach for spinal anesthesia is associated with a significantly lower occurrence of post-dural puncture headache compared to the median approach in cesarean section patients.