| Clinical Study of Postspinal Headache following Cesarean Section . |
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Koo Mee Oh, Choon Hi Lee |
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Department of Anesthesiology, Ewha Womans University College of Medicine, Seoul, Korea. |
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| Abstract |
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Spinal anesthesia is a type of regional anesthesia obtained by blocking the spinal nerves with the introduction of local anesthetic solutions into the subarachnoid space.
Historically, in 1885 Corning accidentally introduced spinal anesthesia and in 1898 August Bier produced true spinal anesthesia in animal and man for the first time. Even though spinal anesthesia is widely used because of many advantages, headache, the most common untoward complication, has been said to be the greatest single deterrent to the patient who is considering this anesthetic technique. The obstetric patient is more likely to suffer from headache than the surgical patient after spinal anesthesia. Authors observed the incidence of post-spinal headache in 288 patients who received spinal anesthesia for cesarean section at department of anesthesiology in Ewha Womans University Hospital from March 1979 to February 1980. The patients were divided into 2 groups according to the needle size, used to perform spinal tap i.e. 22 and 25 gauge (G). The results obtained were as follows; 1) Among 288 cases, 63 cases underwent spinal anesthesia with 22 G and 225 cases with 25 G. 2) The indications for cesarean section were previous cesarean section(36. 8%), cephalopelvic disproportion(20.5%), malpresentation(10. 7%) and placenta previa(4. 2%) in order of frequency. 3) In the age distribution, the majority(72.6%) was in 20~29 years age group. 4) The incidence of headache was higher in the group of 22 G(17.8%) than in 25 G group (9. 8%), but there was no statistical significance. 5) The onset of headache was within 2 or 3 days after spinal anesthesia in both groups.
6) In the severity of headache, the group of larger size needle showed headache worse than that of small size needle.
7) In the location of headache, generalized headache developed in 54. 5% of cases in the group of 22 G needle and frontal headache developed in 40. 9% in the group of 25 G needle. 8) Ocular complication associated with headache noted in 2 cases of the group of 25 G needle. There was no auditory complication. |
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