Prevalence and associated factors of Post Dural Puncture Headache (PDPH) after Spinal Anesthesia among adult elective Patients in Saint Paul’s Hospital Millennium Medical College

Abstract

Abstract Background: Post-dural puncture headache is defined as a bilateral headache that is position related, with symptoms improving when supine and worsening when upright. Post-dural puncture headache is thought to be caused by chronic cerebrospinal fluid leakage that exceeds cerebrospinal fluid production following lumbar puncture. There is limited information available on the prevalence and risk factors for post-dural puncture headache after spinal anesthesia among adult elective surgery patients at Saint Paul Hospital Millennium Medical College. Understanding these aspects is critical to improve anesthesia practices and patient outcomes. Objective: To assess the prevalence and associated factors of post Dural puncture headache after spinal anesthesia among adult elective patients in Saint Paul Hospital Millennium Medical College, 2025 Method: Institutional based cross sectional study will be conducted from October 01 to November 30, 2025 at Saint Paul Hospital Millennium Medical College elective surgery patients. After pre-testing a structured quantitative tool, it will be applied on all patients undergoing elective surgery using interviewer-administered structured questionnaire. Data will be checked, coded, entered and analyzed in SPSS V-25. Descriptive statistic will be presented using text, figures and tables. The association between variables will be analyzed with bivariate and multi variable logistic regression. A statistical significance will be declared at p value < 0.05, with 95% confidence interval. Result: A total of 440 adult elective surgical patients who received spinal anesthesia were included in the study. The prevalence of post-dural puncture headache (PDPH) was 25.5%. In multivariable logistic regression analysis, obesity (AOR = 0.48, 95% CI: 0.28–0.82), previous history of PDPH (AOR = 0.37, 95% CI: 0.19–0.75), and number of spinal attempts (AOR = 5.17, 95% CI: 2.31–11.53) was significantly associated with PDPH-free status. Conclusion: PDPH is a common complication following spinal anesthesia in adult elective surgical patients. Obesity, previous history of PDPH, and multiple puncture attempts increase the likelihood of developing PDPH, whereas achieving spinal anesthesia on the first attempt markedly reduces this risk. Improving procedural success and identifying high-risk patients may help decrease the burden of PDPH.