Chandannath

Researchers are studying how different altitudes affect the chance and severity of postdural puncture headache (PDPH) after spinal anesthesia for cesarean delivery. They believe that women living at high altitudes might have a higher risk of PDPH compared to those at lower altitudes. This is a prospective cohort study conducted in two locations in Nepal: a high-altitude site in Jumla at 2514 meters above sea level, and a low-altitude city in Dharan at 350 meters. Eligible participants are women scheduled for elective or non-elective cesarean delivery with spinal anesthesia. The anesthesia is given while sitting, using a 25-gauge pencil point spinal needle at the L3-L4 or L4-L5 vertebral space. Researchers will record baseline characteristics, including anxiety, depression, chronic pain, and existing headaches. The diagnosis of PDPH will follow the international headache society's criteria. During the study, participants will be monitored for the development of PDPH up to seven days after spinal anesthesia. Researchers will assess the number of patients who experience PDPH and track symptoms based on established guidelines. Patients who move between altitudes shortly after delivery or experience major complications will be excluded. The study aims to better understand how altitude influences PDPH occurrence and severity in women undergoing cesarean delivery under spinal anesthesia.