Evaluation of the relationship between post spinal headach and cerebral oxygen saturation in caesarean patients

Nowadays, there is a tendency to increase in the application of neuraxial anesthesia techniques in cesarean section compared to general anesthesia. Post spinal puncture headache, one of the most common complication of spinal anesthesia which is a widely preferred one of these techniques, may affect the postoperative recovery and quality of life in patients with caesarean section. Near infrared spectroscopy (NIRS) is a real-time monitoring method of the tissue oxygen saturation. Near infrared spectroscopy monitoring has been widely used in clinical practice for 20 years associated with features such as non-invasive and minimal technical information requirement and providing continuous information. It is accepted that cerebral vasodilation is mainly involved in the pathophysiology of post spinal puncture headache and emerging vasodilation may cause a change in cerebral perfusion pressure. If the change in cerebral perfusion pressure could be detected by NIRS, it may be used as a parameter in the diagnosis and follow-up of PSPH. In this study, our aim is to investigate the relationship between NIRS and PSPH in patients with elective cesarean section under spinal anesthesia. Patients who had elective cesarean section under spinal anesthesia were included in the study. Demographic, sociocultural and anxiety states of these patients were recorded at the ward before surgery. Mean arterial pressure values, and NIRS values at preoperative 5th min, intraoperative 1st min, 4th min, 7th min, 10th min, 15th min, 30th min and postoperatively at 24 hours and the presence of intraoperative nausea, vomiting, hypotension, bradycardia of the patients were recorded. All patients were followed-up for 15 days in the development of postoperative PSPH. Patients were divided into two groups of those without PSPH as group A and those with PSPH as Group B. In this study, there was a negative relationship between PSPH development and body mass index (BMI) (p; 0.008). A positive correlation was found between the decrease in NIRS values and MAP values at the intraoperative 4th and 7th min. (p < 0.05, r < 0.4). Negative correlation was found between NIRS values changes and nausea development at the intraoperative 4th, 7th and 10th min (p < 0.05, r < 0.4). No vii significant difference was found between intraoperative and postoperative NIRS value changes according to preoperative NIRS values and NIRS values between groups (p > 0.05). In conclusion, this study showed that NIRS, which is a method used for following tissue perfusion, is insufficient to predict perioperative PSPH. Keywords: Spinal anesthesia, caesarean section, post spinal headache, Near infrared spectroscopy.