The aim of this study is to examine the effects of altitude (high altitude versus low altitude) on incidence and severity of postural puncture headache (PDPH) following spinal anaesthesia for caesarean delivery. The investigators hypothesized that the risk of PDPH would be higher in highlander parturients than in lowlander parturients.
Parturient, aged more than or equal to 18 years
American society of Anesthesiologist 2 and 3
Scheduled for elective and non-elective (category 2 & 3) caesarean delivery with spinal anesthesia
Native to their resident altitude i.e., those born, raised, and have continuously lived at the same altitude, at least for the past 1 year.
Hypertensive disorder
Cerebrovascular disease
Mental disorder (schizophrenia and other psychotic disorders)
Known fetal anomalies
Parturients planned for elective and non-elective (category 2 \& 3) caesarean section under spinal anaesthesia.
Cohort
Prospective
Not listed
Number of patients with postdural puncture headache
The diagnosis of post-dural puncture headache will be based on the international headache society ICDH-3 criteria: a headache that occurs within 5 days of a dural puncture, is located in the occipital and/or frontal areas, worsens within 15 min of sitting or standing and alleviates within 15 min after lying down, associated with at least one of the following features: neck stiffness, nausea, vomiting, photophobia, and tinnitus, and resolves either spontaneously within 1 week or within 48 h after effective treatment.
Number of patients with severity of postdural puncture headache
using a numeric rating scale (NRS), with 0= NO pain 10=worst imaginable pain, and classified as none (NRS=0), mild (1-3), moderate (4-6), and severe (7-10)
Number of patients with non-postdural puncture headache
Headache that is not related to posture
Number of patients who received treatment for postdural puncture headache
paracetamol, NSAID's, caffeine, opioids, glossopharyngeal nerve block, sphenopalatine ganglion block and epidural blood patch
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B.P. Koirala Institute of Health Sciences
Lead sponsor
Karnali Academy of Health Sciences
Collaborator
