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This study aims to investigate the relationship between spinal needle size and optic nerve sheath diameter (ONSD) in patients who develop post-dural puncture headache (PDPH) after spinal anesthesia. ONSD is measured using ultrasound, which helps estimate changes in brain pressure. The study also examines whether the severity of headache is related to ONSD. Adult patients aged 18 to 75 years who develop PDPH will be included. This research will be conducted at Konya City Hospital and is expected to last for approximately six months.
This prospective observational study investigates the relationship between spinal needle gauge and optic nerve sheath diameter (ONSD) in patients who develop post-dural puncture headache (PDPH) following spinal anesthesia. ONSD is measured using ultrasound as a non-invasive marker of intracranial pressure. The study also aims to evaluate the association between headache severity, assessed by the Visual Analog Scale (VAS), and ONSD values. Patients aged 18-75 years with PDPH will be included, and data on spinal needle gauge, ONSD, and VAS scores will be analyzed. The study is being conducted at a single tertiary care center and aims to contribute to understanding the physiopathology of PDPH and its relation to procedural factors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 25 | Group 25G: Patients who underwent spinal anesthesia with a 25-gauge needle | ||
| Group 27 | Group 27G: Patients who underwent spinal anesthesia with a 27-gauge needle |
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| Measure | Description | Time Frame |
|---|---|---|
| Optic nerve sheath diameter (ONSD) | The primary outcome is the measurement of optic nerve sheath diameter (ONSD) via ocular ultrasound in patients who develop postoperative headache attributed to dural puncture. This non-invasive assessment is used to estimate intracranial pressure. The aim is to evaluate whether different spinal needle gauges affect ONSD measurements. | Within 4 hours of anesthesia consultation for postoperative headache |
| Measure | Description | Time Frame |
|---|---|---|
| Pain severity assessed by Visual Analog Scale (VAS) | Pain severity will be scored using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain), during the anesthesia consultation conducted for postoperative headache. This measure will be compared with ONSD values. | Within 4 hours of anesthesia consultation for postoperative headache |
| Measure | Description | Time Frame |
|---|---|---|
| Spinal Needle Gauge | The gauge (diameter in G) of the spinal needle used for the neuraxial procedure will be extracted from anesthesia records. The goal is to assess whether the spinal needle size is associated with ONSD measurements in patients with postoperative headache. | Retrieved from procedure documentation at the time of spinal anesthesia |
Inclusion Criteria:
Exclusion Criteria:
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The study population consists of adult patients aged 18 to 75 years who develop post-dural puncture headache (PDPH) following spinal anesthesia. All participants are evaluated and monitored at a tertiary care center and are classified as ASA physical status I to III.
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| Name | Affiliation | Role |
|---|---|---|
| Nuran AKINCI EKİNCİ | Konya City Hospiital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Konya City Hospital | Meram | Konya | 42020 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38254029 | Background | Wang P, Zhou X, Sheng F, Wang X, Shi C, Feng W. Ultrasonic optic nerve sheath diameter can be used as a diagnostic measure after accidental dural puncture during cesarean section: a case report. BMC Anesthesiol. 2024 Jan 22;24(1):35. doi: 10.1186/s12871-024-02418-8. | |
| 21693468 | Background | Dubost C, Le Gouez A, Zetlaoui PJ, Benhamou D, Mercier FJ, Geeraerts T. Increase in optic nerve sheath diameter induced by epidural blood patch: a preliminary report. Br J Anaesth. 2011 Oct;107(4):627-30. doi: 10.1093/bja/aer186. Epub 2011 Jun 21. |
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| ID | Term |
|---|---|
| D051299 | Post-Dural Puncture Headache |
| D019585 | Intracranial Hypotension |
| ID | Term |
|---|---|
| D051271 | Headache Disorders, Secondary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| D009422 | Nervous System Diseases |