Incidence and Risk Factors of Post-Dural Puncture Headache
Keywords:
Post-Dural Puncture Headache, Spinal Anesthesia, Risk Factors, Incidence, Needle Gauge.Abstract
Background: Post-dural puncture headache (PDPH) is a frequent and debilitating complication following spinal anesthesia and diagnostic lumbar puncture. Its occurrence can prolong hospital stays and increase morbidity.
Methods: A prospective observational study was conducted at Clearmedi Paridhi Hospital, Gwalior, from June 2025 to May 2026. A total of 100 patients undergoing procedures with intentional dural puncture were enrolled. Data on demographics, procedural details, and clinical outcomes were collected.
Results: The overall incidence of PDPH was 24%. The incidence was significantly higher in younger patients (18-40 years, 58.3%), females (70.8%), and those with a lower body mass index. A higher incidence was observed with the use of larger Quincke needles (20G, 45.8%) and when the bevel orientation was perpendicular to the dural fibers (87.5%). The most common onset was within 24-48 hours (54.2%), and the pain was predominantly frontal (37.5%) and throbbing in nature (62.5%).
Conclusion: PDPH remains a common complication, with significant risk factors identified as younger age, female sex, larger needle gauge, and perpendicular bevel insertion. Implementing prophylactic measures, such as using smaller, atraumatic needles with parallel bevel orientation, is crucial to reduce its incidence.
