THE INCIDENCE AND CAUSES OF HEADACHES AFTER SPINAL ANESTHESIA IN CESAREAN SECTIONS

Nawal Majed Alatich*, Najwa Ragmani

ABSTRACT

Background: Spinal anesthesia is the most commonly used anesthesia technique for cesarean section with a prevalence rate of 80% - 95%. The most common complications of spinal anesthesia are post-dural puncture headache associated with dural puncture and cerebrospinal fluid leak. Methods: A cross-sectional descriptive study was conducted in Damascus Governorate during the period from 1/11/2024 to 5/1/2025. Data from 141 patients were studied through a questionnaire distributed in paper and electronic form, containing a set of questions that serve the research objective. Results: Our study included 141 patients who underwent cesarean section under spinal anesthesia. Their ages ranged from 21-58 years, and the most participating age group was "20-30 years" (67.5%). Patients were classified by the American Society of Anesthesiologists (ASA): "ASA1" (95.7%), "ASA2" (4.3%). History of spinal anesthesia (48.9%). Number of attempts with a puncture needle: "once" (39.7%), "twice" (22.7%). Academic level of the person performing the spinal block: "physician" (44.7%), anesthesia technician (55.3%). Symptoms experienced by patients after spinal anesthesia: "nausea/vomiting" (48.3%), "tinnitus" (17.9%), "foveal rigidity" (15.5%), "double vision" (11.1%). Conclusion: In our study, the incidence of headache after dural puncture was 3.5%. Studies show that factors such as needle size, number of attempts, body mass index, and anesthesiologist experience are associated with increased incidence of headache. Repeated attempts were observed to increase the likelihood of headache by 1.5 to 4 times. Headache rate was higher when anesthesia was administered by an anesthesia technician than by an anesthesiologist. Our study did not show an association between these factors and headache incidence, which is attributed to the difference in sample sizes studied.

Keywords: Post-dural headache, post-spinal headache, Cesarean section.