A retrospective evaluation of the effect of patient position on postdural puncture headache: is sitting position worse?

Abstract

Background: Postdural puncture headache is an unpleasant complication of spinal anesthesia. We
aimed to investigate the association between the position in which spinal anesthesia was performed and
occurrence of postdural puncture headache.
Methodology: Records of patients who underwent cesarean section between January 2013 and November
2013 with spinal anesthesia were examined retrospectively. Patients older than 18 were included in
the study. Convertion to general anesthesia was the exclusion criteria. Demographic data of patients
(age, weight, height and physical status), comorbid diseases, position of patient while performing spinal
anesthesia, the number of spinal puncture attempts and the incidence of postdural puncture headache
were recorded.
Results: A total of 149 records of patients, who met the inclusion criteria, were analysed (sitting position
n=72 and lateral position n=77). Postdural puncture headache developed in 11 (15.2%) in the sitting
position and 10 (12.9%) in the lateral position (p>0.05). There was no difference between groups in
terms of age, weight, height, American Society of Anesthesiologists (ASA) physical status, comorbid
diseases, attemp numbers and frequency of postdural puncture headache (p>0.05).
Conclusion: We conclude that the patient position during spinal anesthesia performance does not affect
postdural puncture headache incidence. Therefore, one of them may be preferred according to the
experience of anesthesist.