A COMPARATIVE STUDY TO KNOW THE EFFECT OF POSITION DURING SPINAL ANESTHESIA ON POSTDURAL PUNCTURE HEADACHE IN LOWER ABDOMINAL SURGERIES

Background: Pain is pathologic entity, noxious stimulus and a most common problem challenging the anaesthetists. Spinal anaesthesia is a commonly used technique for providing surgical anaesthesia to patients undergoing urological, gynecological, abdominal and lower limb surgeries (1). PDPH was first described by August Bier in 1898. The incidence of PDPH after spinal anaesthesia in obstetric anaesthesia is 1% - 6%. The risk factors of PDPH after spinal anaesthesia are needle size, direction of bevel, needle design, number of lumbar puncture attempts, age, sex, pregnancy, and previous history of PDPH(4). Objectives: To evaluate the effect of position during spinal anaesthesia on PDPH in patients undergoing lower abdominal surgeries and to study complications associated with spinal anaesthesia. Methods: After approval from the ethical committee and informed written consent from the patient. A prospective randomised study was conducted with hundred ASA grade I and II patients aged between 18-60 years undergoing lower abdominal surgeries and were divided into two groups of 50 each .Group A and Group B, where first group were given spinal in lateral position and latter group in sitting position. The intensity of PDPH was assessed postoperatively using a Numeric Rating Scale immediately on either postoperative day (POD) one, two, or three as described to the patient during the preoperative visit. Results: There was a significant decrease in incidence and severity of PDPH when the subarachnoid block was given in the lateral recumbent position as compared to that given in the sitting position. Conclusion: Hence, lateral position is preferred for spinal anaesthesia for patients undergoing lower abdominal surgeries.