{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:53:30Z","timestamp":1747191210028,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2023,8,10]]},"abstract":"<jats:p>Background. The proportion of obstetric mothers reporting postspinal headache (PSH) in Uganda is high. The aim of this study is to determine the incidence and factors associated with postspinal headache among obstetric patients who underwent spinal anesthesia during cesarean section at a tertiary hospital in Western Uganda. Methods. A prospective cohort study was done on 274 consecutively enrolled obstetric patients at Fort Portal Regional Referral Hospital (FRRH) from August to November 2022. Pretested questionnaires were used to obtain the data needed for analysis. The data were entered into Microsoft Excel version 16, coded, and transported into SPSS version 22 for analysis. Descriptive statistics was used to determine the incidence of postspinal headache. Binary logistic regression was computed to obtain factors associated with postspinal headache. Results. The overall incidence of postspinal headache was 38.3% (95% CI: 32.5\u201344.4). Factors with higher odds of developing postspinal headache included using cutting needle (aOR 3.206, 95% CI: 1.408\u20137.299, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.006<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), having a previous history of chronic headache (aOR 3.326, 95% CI: 1.409\u20137.85, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.006<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), having lost &gt;1500\u2009mls of blood intraoperatively (aOR 6.618, 95% CI: 1.582\u201327.687, <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.010<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), initiation of ambulation &gt;24\u2009h after spinal anesthesia (aOR 2.346, 95% CI: 1.079\u20135.102, <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.032<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), allowing 2-3 drops of cerebrospinal fluid (CSF) to fall (aOR 3.278, 95% CI: 1.263\u20138.510, <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.015<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>), undergoing 2 puncture attempts (aOR 7.765, 95% CI: 3.48\u201317.326, <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>p<\/k:mi>\n                        <k:mo>\u2264<\/k:mo>\n                        <k:mn>0.001<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>), 3 puncture attempts (aOR 27.61, 95% CI: 7.671\u201399.377, <jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                        <m:mo>\u2264<\/m:mo>\n                        <m:mn>0.001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>) and &gt;3 puncture attempts (aOR 20.17, 95% CI: 1.614\u2013155.635, <jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>p<\/o:mi>\n                        <o:mo>=<\/o:mo>\n                        <o:mn>0.004<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>), those prescribed weak opioids (aOR 20.745, 95% CI: 2.964\u2013145.212, <jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>p<\/q:mi>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>0.002<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>), nonsteroidal anti-inflammatory drug (NSAID) with nonopioids (aOR 6.104, 95% CI: 1.257\u201329.651, <jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>p<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.025<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>), and NSAID with weak opioids (aOR 5.149, 95% CI: 1.047\u201325.326, <jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mi>p<\/u:mi>\n                        <u:mo>=<\/u:mo>\n                        <u:mn>0.044<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula>). Women with a body mass index (BMI) of 25\u201329.9\u2009kg\/m2 (aOR 0.471, 95% CI: 0.224\u20130.989, <jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>p<\/w:mi>\n                        <w:mo>=<\/w:mo>\n                        <w:mn>0.047<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>) and a level of puncture entry at L3-4 (aOR 0.381, 95% CI: 0.167\u20130.868, <jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mi>p<\/y:mi>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>0.022<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula>) had lower odds of developing PSH. Conclusions. The incidence of postspinal headache is still high as compared to the global range. This was significantly associated with needle design, amount of cerebro-spinal fluid lost, number of puncture attempts, body mass index, previous diagnosis with chronic headache, amount of intraoperative blood loss, time at start of ambulation, level of puncture entry, and class of analgesic prescribed. We recommend the use of a smaller gauge needle, preventing CSF loss, deliberate attempts to ensure successful puncture with fewer attempts, puncture attempts at L3-4, reducing intraoperative blood loss, earlier ambulation, and prescribing adequate analgesia to reduce the incidence of postspinal headache.<\/jats:p>","DOI":"10.1155\/2023\/5522444","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T17:50:32Z","timestamp":1691689832000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Factors Associated with Postspinal Headache in Obstetric Mothers Who Underwent Spinal Anesthesia from a Tertiary Hospital in Western Uganda: A Prospective Cohort Study"],"prefix":"10.1155","volume":"2023","author":[{"given":"Mohamud Jelle","family":"Osman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy","family":"Muhumuza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yarine","family":"Fajardo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Kwikiriza","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baluku","family":"Asanairi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogers","family":"Kajabwangu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Pascaline Sabine","family":"Ishimwe","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, University of Rwanda, Kigali, Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-2981","authenticated-orcid":true,"given":"Theoneste","family":"Hakizimana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Clinical Medicine and Dentistry, Kampala International University, Western Campus, Ishaka, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1007\/s40140-021-00437-6"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.5603\/gp.a2021.0047"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.4314\/eamj.v87i6.63078"},{"issue":"6","key":"4","article-title":"Assessment of the prevalence and associated risk factors of post dural puncture headache (PDPH) after cesarean section delivery under spinal anesthesia","volume":"8","author":"F. 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Fearon","year":"2008","journal-title":"Journal of Ayub Medical College Abbottabad"},{"issue":"5","key":"18","first-page":"319","article-title":"Incidence and factors associated with post-spinal headache among patient receiving spinal anaesthesia at bharatpur hospital chitwan Nepal","volume":"4","author":"M. K. Bhusal","year":"2017","journal-title":"European Journal of Pharmaceutical and Medical Research"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.3126\/jucms.v9i01.37842"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.36648\/2471-982x.5.1.25"},{"issue":"2","key":"21","first-page":"1","article-title":"The impact of increased body mass index on the incidence and severity of post-spinal headache after cesarean section","volume":"7","author":"M. Hashemi","year":"2019","journal-title":"Journal of Research in Medical and Dental Science"}],"container-title":["Anesthesiology Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/arp\/2023\/5522444.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/arp\/2023\/5522444.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/arp\/2023\/5522444.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T17:50:44Z","timestamp":1691689844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/arp\/2023\/5522444\/"}},"subtitle":[],"editor":[{"given":"Alessandro","family":"Vittori","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":21,"alternative-id":["5522444","5522444"],"URL":"https:\/\/doi.org\/10.1155\/2023\/5522444","relation":{},"ISSN":["1687-6970","1687-6962"],"issn-type":[{"type":"electronic","value":"1687-6970"},{"type":"print","value":"1687-6962"}],"subject":[],"published":{"date-parts":[[2023,8,10]]}}}