CC BY 4.0 · Surg J (N Y) 2019; 05(03): e126-e130
DOI: 10.1055/s-0039-1696967
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Relationship between the Phases of the Menstrual Cycle on the Incidence and Severity of Headache after Spinal Anesthesia

Mahmoud reza Moradkhani
1   Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
,
Arash Karimi
1   Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
,
Zahra Zarei
2   Student of Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
,
Sepideh Vahabi
1   Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
› Author Affiliations
Further Information

Publication History

07 November 2017

22 July 2019

Publication Date:
24 September 2019 (online)

Abstract

Introduction Headache after spinal anesthesia is a common complication, which is caused after dural puncture due to discharge of cerebrospinal fluid and reduction in the volume and pressure. Studies have shown that a variety of factors are involved including needle shape, needle size, patient's sex, age, duration of surgery, history of spinal anesthesia, and history of headaches. One possible factor is the phase of the menstrual cycle. Many studies have investigated the effect of the menstrual cycle on factors such as postoperative nausea, vomiting, propofol injection pain, and sore throat after intubation. Also, many studies have investigated the effect of different phases of the menstrual cycle on migraine headaches. Therefore, we decided to investigate the effect of different phases of the menstrual cycle on headache after spinal anesthesia.

Materials and Methods To determine the relationship between headache after spinal anesthesia and menstrual cycle, the study included all the patients undergoing spinal anesthesia in Shohada Ashayer and Asalian Hospitals of Khorramabad. This cohort study included 279 patients, and data collection tool was a questionnaire. The data from the questionnaire included age, menstrual phase, surgical procedures, pain location, pain intensity, history of spinal anesthesia, history of headache, and headache after spinal anesthesia.

Results There was no statistically significant difference between the location of headache, the history of spinal anesthesia, the location of headache, the history of headache, and menstrual phase.

Conclusion Considering the high incidence of postdural puncture headache in follicular phase, it is recommended that patients with a high risk of headaches undergo spinal anesthesia and surgery in the luteal phase.

 
  • References

  • 1 Rodriques AM, Roy P-M. [Post-lumbar puncture headache]. Rev Prat 2007; 57 (04) 353-357
  • 2 Crock C, Orsini F, Lee KJ, Phillips RJ. Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles. Arch Dis Child 2014; 99 (03) 203-207
  • 3 Beams JL, Rozen TD. Two young women with chronic daily headache and cognitive impairment: why we need to ask about headache in the postpartum period. Obstet Med 2013; 6 (02) 83-87
  • 4 van Oosterhout WP, van der Plas AA, van Zwet EW, Zielman R, Ferrari MD, Terwindt GM. Postdural puncture headache in migraineurs and nonheadache subjects: a prospective study. Neurology 2013; 80 (10) 941-948
  • 5 MacGregor EA, Igarashi H, Wilkinson M. Headaches and hormones: subjective versus objective assessment. Headache Quarterly . Curr Treat Res 1997; 8 (02) 126-137
  • 6 MacGregor EA, Frith A, Ellis J, Aspinall L, Hackshaw A. Prevention of menstrual attacks of migraine: a double-blind placebo-controlled crossover study. Neurology 2006; 67 (12) 2159-2163
  • 7 Echevarria M, Caba F, Rodriguez R. The influence of the menstrual cycle in postdural puncture headache. Reg Anesth Pain Med 1998; 23 (05) 485-490
  • 8 Jabbari A, Alijanpour E, Mir M, Bani Hashem N, Rabiea SM, Rupani MA. Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors. Caspian J Intern Med 2013; 4 (01) 595-602
  • 9 Hanci V, Ayoğlu H, Yilmaz M. , et al. Effect of menstrual cycle on the injection pain due to propofol. Eur J Anaesthesiol 2010; 27 (05) 425-427
  • 10 Sener EB, Kocamanoglu S, Cetinkaya MB, Ustun E, Bildik E, Tur A. Effects of menstrual cycle on postoperative analgesic requirements, agitation, incidence of nausea and vomiting after gynecological laparoscopy. Gynecol Obstet Invest 2005; 59 (01) 49-53
  • 11 Hellström B, Anderberg UM. Pain perception across the menstrual cycle phases in women with chronic pain. Percept Mot Skills 2003; 96 (01) 201-211
  • 12 Haghighi M, Mardani Kivi M, Mohammadzadeh A, Etehad H, Soleymanha M, Mirbolook AR. Evaluation of correlative factor of backache and headache after spinal anesthesia in orthopedic surgery. Journal of Guilan University of Medical Sciences 2012; 21 (82) 31-38
  • 13 Macgregor EA. Menstrual migraine: therapeutic approaches. Ther Adv Neurol Disorder 2009; 2 (05) 327-336