Incidence and associated factors of post-dural puncture headache in a university hospital. A prospective study

Introduction: Despite being the second most frequent complication of neuraxial blocks, the incidence of post-dural puncture headache (PDPH) and its risk factors show wide variability in the scientific literature. Additionally, there are few studies addressing this issue in our setting. Objective: To determine the incidence, population characteristics, and risk factors associated with PDPH following spinal anesthesia in obstetric and non-obstetric patients at a university hospital in Bogotá, Colombia. Methods: This is a prospective, descriptive, and analytical cohort study conducted in adult patients undergoing spinal anesthesia. The incidence of PDPH was calculated, and its association with risk factors was assessed using descriptive and bivariate analyses. Results: A total of 186 patients were included, with a PDPH incidence of 10.8%. Regarding severity, 10% of the cases were mild, 50% moderate, and 40 % severe. A statistically significant association was found between PDPH and female sex (100% women; p = 0.0067), as well as with preeclampsia (OR 4.3; p = 0.01). No statistically significant differences were observed regarding other comorbidities, procedural characteristics, number of attempts, or operator expertise. Conclusions: Although PDPH is usually self-limiting, the condition carries risks and is associated with reduced patient satisfaction. Institutional protocols should focus on at-risk populations and on implementing safe, evidence-based practices.