Incidence and clinical significance of post-dural puncture headache in young orthopaedic patients and parturients

Background and Aims: Post-dural puncture headache (PDPH) is a complication of spinal anaesthesia, influenced mostly by patient’s age, spinal needle size and design and, possibly, female gender. The purpose of this prospective observational study was to compare the frequency and clinical significance of PDPH in two patient groups at high risk for the development of PDPH, namely young parturients and orthopaedic patients, using 26-G and 27-G Quincke needles. Patients and Methods: The study included 56 parturients undergoing Caesarean section and 59 orthopaedic patients undergoing arthroscopic knee surgery, who received standard spinal anaesthesia using 26-G or 27-G Quincke needles. All patients were less than 40 years of age. The patients were visited on postoperative days 1, 2, and 4 or contacted by telephone and evaluated for the presence, characteristics and severity of headache, backache and other possible complications. Only posture dependent headache was regarded as PDPH with severity graded as mild, moderate and severe. Patient satisfaction was assessed by theirwillingness to have spinal anaesthesia in the future. Results: Orthopaedic patients were predominantly male (81.4%) and significantly younger than parturients (27.8±5.5 vs. 33.7±4.7 years, P