Post Dural Puncture Headache in Fibromyalgia after Cesarean Section: A Comparative Cohort Study

Area of Science:

• Anesthesiology
• Pain Medicine
• Obstetrics

Background:

• Fibromyalgia (FMS) patients may be more susceptible to post-dural puncture headache (PDPH) due to central nervous system sensitization.
• The theoretical predisposition to PDPH in FMS patients requires clinical verification.

Purpose of the Study:

• To determine the incidence and chronicity of PDPH in patients with fibromyalgia undergoing spinal anesthesia.
• To compare PDPH rates between fibromyalgia patients and a control group.

Main Methods:

• A case-control study compared 70 fibromyalgia patients (Group 1) with 70 controls without chronic pain (Group 2) undergoing elective cesarean delivery.
• Both groups received spinal anesthesia and were monitored for PDPH development within 48 hours post-operation.
• The study assessed the incidence and duration of PDPH, including persistence for 7 days or more and over 3 months.

Main Results:

• The incidence of PDPH was significantly higher in the fibromyalgia group (25.7%) compared to the control group (14.3%), P < 0.01.
• PDPH persisted for 7 or more days in 11.4% of fibromyalgia patients versus 2.86% of controls.
• A small percentage (2.86%) of fibromyalgia patients experienced PDPH lasting over 3 months.

Conclusions:

• Spinal anesthesia is associated with an increased incidence of PDPH in fibromyalgia patients compared to non-fibromyalgia controls.
• The increased risk of PDPH in fibromyalgia patients does not appear to elevate other postoperative complications.