The Effect of Postoperative Position on the Incidence of Postdural Puncture Headache after Cesarean Section

Objective: The purpose of this study was to study the effect of postoperative position on the incidence of the post-dural puncture headache. Study design: An observational study was conducted on 300 patients scheduled to undergo elective cesarean section under spinal anesthesia. Setting: Departments of Anesthesiology and Obstetric Gynecology, Assiut University Hospital, Assiut, Egypt. Subjects: Three hundreds women (ASA I-II) scheduled for elective cesarean section under spinal anesthesia were included in the present work. Interventions: Patients were classified into two groups (according to the postoperative position in the first postoperative day), group I (n=150) flat position (Recumbent) for 24 h, and group II (n=150) head-up position and allowed to ambulate early (Ambulant). The incidence, severity, and duration of postdural puncture headache were recorded. Results: There were no significant differences between both groups in the incidence, severity, and duration of postdural puncture headache. Conclusions: This study concluded that the strict flat position immediately postoperative, may be of no effect on the incidence and characteristics of postdural puncture headache. The prevalence and characteristics of PDPH were not different between the 6 hour-recumbence and early ambulation groups.