Background: Post-dural puncture headache (PDPH) is a common complication following spinal anesthesiaduring caesarean section. This study aims to evaluate the effect of intrathecal fentanyl in preventing PDPH inwomen undergoing caesarean section under spinal anesthesia.Objectives: (1) To evaluate the efficacy of intrathecal fentanyl in preventing the occurrence of post-dural punctureheadache (PDPH) following caesarean section under spinal anesthesia. (2) To compare the incidence, severity,and duration of PDPH between women who received intrathecal fentanyl and those who received local anestheticalone. (3) To assess the requirement for additional postoperative analgesia in both groups and determine theeffectiveness of intrathecal fentanyl in enhancing post-operative pain control. (3) To monitor and document anypotential side effects or complications associated with the use of intrathecal fentanyl during spinal anesthesia forcaesarean section.Methods: This prospective randomized controlled trial was conducted at Department of Anesthesiology, NetajiSubhas Medical College, and Hospital, Bihta, Patna, Bihar, India for one year. A total of 150 pregnant womenundergoing elective caesarean section under spinal anesthesia were randomly divided into two groups: one groupreceived 25 μg of intrathecal fentanyl along with the local anesthetic, while the other group received localanesthetic alone. Postoperative assessments were made for the incidence, severity, and duration of PDPH,additional analgesic requirements, and any side effects of the intervention.Results: The incidence of PDPH was significantly lower in the fentanyl group compared to the control group.Additionally, the severity and duration of PDPH were reduced in the fentanyl group. Patients in the fentanyl groupalso required less supplementary analgesia postoperatively, demonstrating better pain control. No significantadverse effects were observed in the fentanyl group.Conclusion: Intrathecal fentanyl is an effective adjunct to spinal anesthesia for preventing PDPH in womenundergoing caesarean section. It significantly reduces the incidence, severity, and duration of PDPH and improvespost-operative pain control, making it a valuable option in this patient population.
Ambuj et al. (Thu,) studied this question.