Evaluating the Role of Intrathecal Fentanyl in Reducing Post-Dural Puncture Headache Among Parturient Undergoing Cesarean

Background: Post-dural puncture headache (PDPH) is a frequent and distressing complication of spinal anesthesia in parturient patients undergoing cesarean section, causing discomfort and delaying recovery. Intrathecal fentanyl has been proposed as an adjunct to alleviate the incidence of PDPH. Aim: To evaluate the role of intrathecal fentanyl in alleviating the incidence of PDPH among parturient patients undergoing cesarean section under spinal anesthesia. Methodology: We conducted a prospective, randomized, double-blind trial in 100 ASA II parturient patients, randomized into two groups: Group F (n = 50) received 0.5% hyperbaric bupivacaine with 25 µg fentanyl; Group C (n = 50) received bupivacaine with saline. Subarachnoid block (SAB) was induced using a 25G Quincke needle. The patients were monitored for 72 hours post-operatively, then followed up every day until day 14, when we evaluated PDPH using the Visual Analogue Scale (VAS). Data was analyzed using Chi square and Student's Ttest. Results: Group F demonstrated a lower incidence of both mild (2% vs 6%) and moderate (0% vs 4%) PDPH than Group C. While the distribution, quality, and associated symptoms of headaches (nausea and vertigo, backache) was lower in Group F, these values did not reach statistical significance (p > 0.05). Conclusion: There is potential that intrathecal fentanyl may reduce the severity and incidence of PDPH and suggest a potential protective effect as an adjunct to spinal anesthesia in parturient patients undergoing cesarean section.