Comparing effect of spinal anesthesia, which performed with using sharp point spinal needle to ponctioning dura in coronal and sagittal plane, on postspinal headache and hemodinamic parameters in pregnants

Cesarean section is the most frequently performed obstetric operations worldwide. Regional anesthesia for cesarean section is often preferred. Spinal anesthesia, is one of the oldest and most effective regional anesthesia techniques. Although it is superior to general anesthesia, some complications are also available Among these, some of the most commons are headache, hypotension and low back pain. ASA I-II group 100 patients who have indication for elective caesarean section and no contraindications to spinal anesthesia, were included to this study. The patients were randomly divided into two groups. Group I (coronal n = 50) and group II (sagittal n = 50) spinal anesthesia was performed with 26 G sharp needles. Training period of the assistant who perform spinal anesthesia, the number of attempts for spinal anesthesia, the amount of the fluid given preoperatively and intraoperatively, the range (L3-4, L4-5) in which the spinal anesthesia was performed, and the patient's back movement or not during the attempts were recorded. Mean arterial pressure and heart rate of patients total 60 min of intraoperative and postoperative period were recorded. During postoperative 7 days patients were questioned in terms of headache and back pain complaints. Chi-square and statistical comparison of the rates (Comparison of proportions) were used for statistical assessments. P <0.05 was considered statistically significant. No significant difference were observed among age, height, weight, headache and back pain incidence (P> 0.05). Statistically significant differences not found among number of spinal attempts, the range (L3-4, L4-5) in which the spinal anesthesia was performed, the experience of the practitioner, back movement of the patient during the attempts, the amount of the fluid given to patients preoperatively and intraoperatively, headache and low back pain incidence (P> 0.05). When MAP values compared between groups; while in 10, 15, 30, 40 and 50 minutes statistically significant declines was observed, no statistically significant difference was observed between groups in other measurements times. As a result, using 26 G sharp head spinal needle in spinal anesthesia performed parallel to coronal or sagittal plane, no significant differences found in terms of incidence of creating headache and back pain. Hypotension were observed more frequently in some measurement in coronal group. There is a need for further large studies to arrive at a definite conclusion.