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Category: Volume 07 Issue 05 May 2019
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Title: Is Early Mobilization a Risk Factor for Postdural Puncture Headache (PDPH)?

Authors: Otokwala JG, Obasuyi BI

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.98

Abstract

Postdural puncture headache (PDPH) is a common but debilitating complication following dural puncture from spinal/ epidural anaesthesia or from procedures involving dural puncture. Several risk factors have been implicated in its causation. In environments where the economy of anaesthetic practice is important in considering the type of anaesthesia and the limitations in accessing the ideal devices for the maximum comfort of the patient, it is imperative to define any identified risk factor that may contribute to the causation of PDPH. In this study, we indirectly randomized the patients undergoing spinal anaesthesia for cervical cerclage using low doses of heavy bupivacaine and advised all the parturients to remain in bed after the procedure. 62 parturients who had single shot spinal anaesthesia for elective cervical cerclage at a fertility Centre were involved in the study. 29 (46.8%) of the parturients mobilized within four hours of instituting spinal anaesthesia and 33 (53.2%) parturients remained in bed for over 12 hours post spinal. For the parturients who mobilized early (within 4 hours), 16 (55.2%) developed PDPH while among those that remained in bed beyond 12 hours, only 7(21%) developed PDPH (P = 0.006). The parturients all shared similar risk factors. This observation adds to the debate of the possibility of the link between early mobilization and the development of PDPH.

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Corresponding Author

Otokwala JG

Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt,  Rivers State, Nigeria