Two fluid strategies for prevention of post-dural puncture headache in pregnant females undergoing cesarean section / Nora Amr Agiza ; Supervised Tarek M. Abdelbarr , Mohamed Ibrahim Elsonbaty , Hebatallah Salah Eldin Abdelhameed

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Background and goal of study: Postdural puncture headache (PDPH) is a common complication after cesarean delivery (CD). The role of perioperative fluid therapy in prophylaxis against PDPH is unclear. The aim of this work is to compare restrictive versus liberal fluid therapy in prophylaxis against PDPH after CD. Materials and methods: One hundred full term pregnant women scheduled for elective CD were included in the study. Patients were divided into two groups: Restrictive fluid therapy group (RG) (n=50): did not receive preoperative fluid loading. This group received intraoperative crystalloids at rate of 10 mL/Kg/hour followed by postoperative crystalloids at rate of 2mL/Kg/hour for 3 hours. Liberal fluid therapy group (LG) (n=50): received preoperative fluid loading of 5 mL/Kg, and received intraoperative crystalloids at rate of 10 mL/Kg/hour, followed by postoperative crystalloids at rate of6 mL/Kg/hour. Both groups were compared regarding demographic data, total perioperative fluids, incidence of PDPH, Wong-baker FACES pain-rating scale, postoperative nausea and vomiting, hemodynamics (heart rate and systolic blood pressure), and neonatal outcomes. Results and Discussion: Group RG received median (quartiles) total fluid volume of 1200(1000,1500)mL; whilst, group LG received total fluid volume of 2400 (2200,2600), (p<0.001). Group RG showed lower incidence of PDPH (20% Vs. 44%, P=0.018) compared to group LG. Wong-baker FACES pain-rating scale was lower in group RG compared to LG

Issued also as CD