This study evaluates whether brochure-supported structured telemedicine counseling improves the management of postdural puncture headache after cesarean delivery under spinal anesthesia. Participants received either standard information and routine telephone follow-up or structured telephone counseling supported by a visual information brochure. Pain severity, headache duration, adherence to conservative treatment recommendations, and hospital re-presentation were assessed during the first five days after discharge.

Postdural puncture headache may occur during the first few days after spinal anesthesia and may become apparent after hospital discharge. During this period, patients need to recognize headache characteristics, follow conservative treatment recommendations, and identify symptoms that require medical evaluation.

This prospective, randomized, open-label study included women aged 18-49 years undergoing elective cesarean delivery under spinal anesthesia. Participants were randomly assigned to one of two parallel groups.

The standard-care group received routine verbal information regarding spinal anesthesia, possible complications, and post-discharge precautions, together with standard telephone follow-up.

The intervention group received the same standard information plus a visual brochure entitled "Five Golden Points After Spinal Anesthesia." The brochure provided information about postdural puncture headache symptoms, positional characteristics, conservative measures that could be used at home, warning symptoms requiring medical attention, and relevant contact information. Structured telemedicine counseling reinforced the brochure content, repeated conservative treatment recommendations, answered patient questions, and provided guidance regarding warning symptoms.

Telephone follow-up was performed on days 1, 2, 3, 4, and 5 after discharge. During follow-up, the presence of postdural puncture headache, pain severity measured using the Numerical Rating Scale, associated symptoms, adherence to conservative treatment recommendations, and hospital re-presentation were evaluated. For participants whose headache continued beyond day 5, total headache duration was recorded until complete symptom resolution.

Inclusion Criteria:

• Pregnant women aged 18-49 years
• American Society of Anesthesiologists physical status II or III
• Scheduled for elective cesarean delivery under spinal anesthesia
• Available for telephone follow-up after hospital discharge
• Provided written informed consent

Exclusion Criteria:

• Conversion to or performance of general anesthesia
• Diagnosis of panic disorder or depression
• Hypertension
• Circulatory or coagulation disorders
• Placental abnormalities
• Requirement for perioperative blood transfusion
• Inability to be contacted during the follow-up period

De-identified individual participant data underlying the results reported in the published article will be made available upon reasonable request.

Data will be available beginning three months after publication and for five years following publication.

Data will be shared with qualified researchers who submit a methodologically sound proposal. Requests should be directed to the corresponding author. Access will be subject to institutional and ethical requirements, protection of participant confidentiality, and, where appropriate, completion of a data use agreement.