Comparative Analysis Of Pharmacological And Non-Pharmacological Treatments For Post-Dural Puncture Headache In Parturient At Lady Reading Hospital, Peshawar

Abstract

Post-Dural puncture headache (PDPH) is a common and distressing complication following spinal anesthesia, particularly in obstetric patients undergoing cesarean sections. Despite its prevalence, management practices remain inconsistent, especially in resource-limited settings such as Pakistan. The absence of standardized protocols has led to variable clinical outcomes and suboptimal patient experiences. This study aimed to compare the effectiveness of pharmacological and nonpharmacological treatments for PDPH in parturient at Lady Reading Hospital, Peshawar, with the goal of identifying practical, safe, and resource-efficient management strategies. A descriptive cross-sectional study was conducted involving 114 anesthesia professionals, including consultants, residents, and technologists. Data were collected through a structured questionnaire assessing clinical experiences, treatment preferences, and perceptions of efficacy. Descriptive statistics and frequency distributions were analyzed using SPSS. The majority of respondents (53.5%) preferred a combination of pharmacological and non-pharmacological treatments. While epidural blood patch was recognized as the gold standard by 65.8% of participants, conservative methods such as bed rest and hydration were considered the most accessible and cost-effective by 71.1%. Pharmacological treatments were generally perceived as only mildly to moderately effective. Preoperative counseling practices varied, with only 41.2% of providers consistently informing patients about PDPH. A multimodal approach is favored for PDPH management, yet gaps persist in clinical consistency, access to advanced interventions, and patient education. The study highlights the need for evidence-based institutional protocols, enhanced training, and awareness to improve maternal outcomes and healthcare efficiency in Pakistan.