Effect of Intra-Ligamental Injection Before Removal of Spinal Needle After Spinal Anesthesia on Post Spinal Headache, no Injection Versus Normal Saline Versus Dexamethasone
Year: 2025
Type: article
Abstract: Among the most frequent side effects of spinal anesthesia is post-dural puncture headache (PDPH), which occurs in 1-40% of scenarios. In forty percent of cases, invasive treatment options such as epidural blood patches may be necessary, and it might result in significant comorbidity. The dural healing is facilitated by fibroblastic growth; this growth is thought to be enhanced by the damage to the surrounding tissues and the presence of a blood clot. Needle trauma, normal saline and dexamethasone all can produce local irritation that might enhance fibroblastic proliferation. Aim of the study: Assessment of intra-ligamental injection of normal saline and dexamethasone on the incidence, duration and severity of post-spinal headache following spinal anesthesia. Patients and Methods: 75 patients were randomly selected and enrolled into this study. They were divided into three equal groups; control group (C) received nothing, group (D) received dexamethasone, and group (N) received normal saline. After performing spinal block with heavy bupivacaine, in groups D and N the needle was withdrawn for about 0.5 cm to make sure the tip of the needle is in the interspinous ligament then either 1 ml of normal saline or 1 ml of dexamethasone solution was injected before complete removal of the needle. The incidence, severity, onset, and duration of PDPH were noted at 24 hours, 72 hours, and 7 days after spinal anesthesia. The meningeal headache index was used to grade the headache's severity. Result: The incidence of PDPH through 1 week was 4 (16%) for both dexamethasone and the control group, and 2 (8%) for the normal saline group, with non-statistically significant differences (p-value more than 0.05). Additionally, there is no statistically significant difference in headache severity. The onset of headaches was delayed in the normal saline group compared with the control group, p-value less than 0.05. Duration of headache was comparable in the three-study group with a p-value of > 0.05. Conclusion: Both normal saline and dexamethasone are not effective in the prevention of post- dural puncture headache after spinal anesthesia.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412361927