The Effect of Geographic Altitude on Frequency of Postdural Puncture Headache. Prospective Multicentric Study

Background: Many risk factors have been described for (Postdural puncture headache) PDPH. No study compared incidence of PDPH at different geographic altitudes before. We think that geographic altitude may influence the incidence of PDPH. Material and methods: This is a prospective, multicentric, observational and case-control study conducted in two different cities. One of these cities has 1890 meters altitude, the other is placed the sea side. A total of 160 patients who had been operated for caesarean section or simplistic anal surgery under spinal anesthesia were divided into four equal groups: At high altitude (H): caesarean section (Group HCS) and anal surgery (Group HAS) groups; At low altitude (L): caesarean section (Group LCS) and anal surgery (Group LAS) groups. The presence of PDPH and patient's verbal rating scale (VRS) at the worst painful moment through the first five days were asked to all patients and were discussed. Results: The frequency of patients who stated experiencing PDPH in Group HCS were higher than those in Group LCS (p=0. 029). The patients experiencing PDPH in Group HAS were also higher than those in Group LAS (p=0.039). The total number of PDPH in patients living at high altitude (n=24) were higher than those living at low altitude (n=7), (p=0. 001). VRS values in Group HCS were also higher than those in Group LCS. VRS values in Group HAS were also higher than those in Group LAS. Conclusion: Geographic altitude seems to have a role in PDPH incidence and severity.