Effect of Supine versus Sitting Position on Post-Dural Puncture Headache among Patients Receiving Spinal Anesthesia

Document Type : Original Article

Author

Assistant professor of Medical-Surgical Nursing Faculty of Nursing, Menoufia University, Egypt

Abstract

Background: One of the most commonly reported complications associated with spinal anesthesia is post-dural puncture headache, even while, the precise mechanisms causing post-dural puncture headache are still not well known, which if left untreated, can lead to severe complications such as subdural hematoma and convulsions. The aim of the current study was to evaluate the effect of supine versus sitting position on post-dural puncture headache among patients receiving spinal anesthesia. Design: A quasi-experimental research design Sitting: The present study was carried out at the Menoufia University Hospital's urology and orthopedic surgery departments, Menoufia Governorate, Egypt. Subjects: A purposive sample of 100 adult patients with spinal anesthesia who volunteered to participate in the study and met the inclusion criteria were randomly divided evenly into two study groups. Tools: For data gathering, three instruments were utilized in this study are: 1.Patients' characteristics questionnaire was used to analyze their sociodemographic features, as well as their past, present, and family medical history 2. Visual Numerical Analogue Scale (VAS) was adopted for headache Severity evaluation 3.Headache Impact Index had been adopted to grade severity of post-dural puncture headache's associated complications. Results: There were a statistically significant decrease in post-dural puncture headache's incidence, severity and associated complications among supine position group (study group I) subjects than among sitting position group (study group II) subjects with statistically significant differences existed between the two studied groups. Conclusion: Maintaining patients in supine position for the first 72 hours post spinal anesthesia as a management technique significantly improved their post-dural puncture headache's incidence, severity and associated complications. Recommendations: Designing a plan of care for post-spinal anesthesia patients should include positioning as a simple management technique that could lead to preferable effects regarding their post-dural puncture headache's incidence, severity and associated complications. Replication of the current study on a larger sample size and for longer follow-up period to allow for results' generalization

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