Optic nerve sheath diameter as a prognostic tool for postdural puncture headache in pregnant women undergoing caesarean section under spinal anesthesia: A cross-sectional study
N. Amulya, Lavanya Kaparti, Suresh N. KumarABSTRACT
Context:
Postdural puncture headache (PDPH) is a common and debilitating complication following spinal anesthesia in obstetric patients, with few objective tools available for early prediction. Optic nerve sheath diameter (ONSD) measured by ultrasonography is a noninvasive surrogate marker of intracranial pressure changes and may aid in early risk stratification.
Aim:
To evaluate the prognostic utility of ONSD measurements in predicting PDPH among pregnant women undergoing cesarean section under spinal anesthesia.
Materials and Methods:
This cross-sectional study included 88 pregnant women aged between 18 and 40 years undergoing cesarean section under spinal anesthesia. ONSD was measured using ultrasonography with a 13–6 MHz probe at baseline (T0) and at 4 (T4), 24 (T24), 48 (T48), and 72 h (T72) postprocedure. PDPH was diagnosed using International Classification of Headache Disorders criteria.
Statistical Analysis Used:
Data were analyzed using SPSS version 22. Continuous variables were expressed as mean ± SD and categorical variables as frequencies and percentages. Student’s
Results:
PDPH occurred in 12 patients (13.6%). Baseline ONSD values were comparable between groups. Patients who developed PDPH showed significantly lower ONSD values from T4 onward (
Conclusion:
ONSD measurement at 72 h postspinal anesthesia is a sensitive and clinically useful prognostic tool for predicting PDPH in obstetric patients and may be incorporated into routine postoperative monitoring.