POST DURAL PUNCTURE HEADACHE - A COMPARISON OF MIDLINE an‎d PARAMEDIAN APPROACHES

The purpose of this study was to compare two approaches for dural puncture regarding post dural puncture headache (PDPH) in general population presenting for surgery under spinal anaesthesia. A comparative observational study was conducted at Sir Ganga Ram Hospital, Lahore, from March 2005 to July 2005. Twenty five patients, planned to undergo elective surgery under spinal anaesthesia, were randomly assigned to each of the two groups. Group-M received sub arachnoid block (S.A.B.) using midline approach for dural puncture whereas in Group-P paramedian approach was utilized. Both groups were observed for PDPH for three post operative days. The PDPH was much less frequent in P group compared to M Group, thus it was concluded that paramedian approach should be used frequently for dural puncture for spinal anaesthesia