1Senior Resident, Department of Anaesthesiology, School of Medical Sciences & Research, Sharda University, Greater Noida, Uttar Pradesh, India. Email: dralkaverma29@gmail.com
2*Professor, Department of Anaesthesiology, School of Medical Sciences & Research, Sharda University, Greater Noida, Uttar Pradesh, India. Email: dr.manishagarwal09@gmail.com (Corresponding Author)
3Assistant Professor, Department of Anaesthesiology, F.H. Medical College & Hospital, Etamdapur, Agra, Uttar Pradesh, India. Email: rahul8agarwal@gmail.com
Background: Post-dural puncture headache (PDPH) is a known complication of spinal anaesthesia that can severely interfere with the patient's postoperative recovery and satisfaction. Even with the progress of anaesthetic techniques and tools, PDPH still happens, especially in people who are at high risk. Knowing how often it happens and what risk factors are involved is crucial for its proper prevention and treatment.
Objective: To evaluate the incidence of post-dural puncture headache following spinal anaesthesia and to analyse patient-related and procedure-related risk factors, with particular emphasis on spinal needle design and technique.
Methods: A narrative review of the literature was conducted on published prospective and retrospective cohort studies, randomized controlled trials, and meta analyses that have explored PDPH after spinal anaesthesia. Data relevant to incidence, patient demographics, spinal needle characteristics, and procedural variables were gathered and analysed descriptively to find consistent trends and clinically significant associations.
Results: The frequency of PDPH changed a lot from one study to another, with some showing an occurrence as low as 2% while others as high as 28%, depending on the type of patients and the anesthetic technique used. Compared to the use of small gauge atraumatic pencil point needles, the use of cutting spinal needles and larger needle gauges was associated with a significantly greater incidence of PDPH. Pregnant women delivering babies through cesarean section are more prone to PDPH compared to other non pregnant populations. In fact, younger age, female gender, and several dural puncture attempts were always the three independent risk factors found in the studies. At the same time, the use of atraumatic needles did not negatively impact the efficiency rate of spinal anaesthesia.
Conclusion: Post-dural puncture headache continues to be one of the many complications of spinal anaesthesia. The main factors that detach the risk from being non modifiable are the design of the spinal needle and the therapist's technique. Making small gauge atraumatic needles a part of the routine, limiting the number of punctures, and paying close attention to the technical details can significantly decrease the frequency of PDPH and raise the level of patients' satisfaction.
Keywords: Post-dural puncture headache, Spinal anaesthesia, Spinal needle design, Atraumatic needle, Risk factors; Incidence.
How to cite this article: Verma A, Agarwal MK, Agarwal R. Incidence and Risk Factors of Post-Dural Puncture Headache After Spinal Anaesthesia. Int J Drug Deliv Technol. 2026;16(2): 684-692. DOI: 10.25258/ijddt.16.2.73
Source of support: Nil.
Conflict of interest: None