Comparison of Postdural Puncture Headache in Median and Paramedian Approach under Spinal Anesthesia in Cesarean Section

Background: Post dural puncture headache (PDPH) is a known complication of spinal anesthesia due to constant spillage of cerebrospinal fluid from the dural puncture site. Spinal anesthesia can be performed by two approaches i.e., midline & paramedian. The results regarding incidence of PDPH with these approaches are debatable. Aim: To compare the frequency of PDPH with spinal anesthesia using midline & paramedian approach in patients of cesarean section. Methodology: This was a randomized controlled trial conducted at department of Anesthesia & ICU, Lahore General Hospital. 100 cases were included through Non-Probability, Purposive Sampling. Patients were randomly divided into two groups. One group received sub-arachnoid block via midline and other group received sub-arachnoid block via paramedian approach. After surgical procedure the patients were admitted in department of gynecology & obstetrics and followed for PDPH for 1st 2nd & 3rd post-operative days. Results: Out of 100 patients 6 patients developed PDPH; 2 were from Group A & 4 were from Group B. P value was 0.0678. Conclusion: PDPH was more frequent with paramedian approach when compared to midline approach.