الفهرس | Only 14 pages are availabe for public view |
Abstract Spinal anesthesia (SA) is popular for its effectiveness in producing anesthesia with excellent intraoperative neuromuscular paralysis and in generating analgesia for relieving post-operative pain if continuously infused. As the SA techniques are popularly used, post-dural puncture headache (PDPH), a common iatrogenic complication resulted from post spinal taps or accidental dural puncture subsequent to epidural block, is frequently reported and becomes a challenge to health caregivers (Chin & van Zundert, 2023). So nursing intervention is critical in minimizing incidence of PDPH because early identification of precipitating factors is extremely important in diagnosis and treatment of this condition. These factors would consequently lead to delay of the healing process of patients’ wounds, and result in longer hospital stay and subsequent financial load on the patients and their families, as well as the healthcare system. Moreover, PDPH might give patients a bad experience with spinal anesthesia that makes them reluctant to use it again (Eldoushy, 2023). The purpose of this study was to determine the effect of nursing intervention on post dural puncture headache and satisfaction among patients undergoing spinal anesthesia. Setting: The study was carried out at general surgery department of Menoufia Emergency Hospital, Shibin El-Koum, Menoufia Governorate, Egypt. Subjects: A purposive sample of 321 adult patients who fulfilled the inclusion criteria was assigned randomly and equally divided into three groups. 1- Control group: comprised of 107 patients, they received hospital routine care.Study group: It was divided into two equal groups: The selection was done according to who likes or dislikes drinking coffee: 2- Study group 1: comprised of 107 patients, they received nursing interventions beside hospital routine care. 3- Study group 2: comprised of 107 patients, they received nursing interventions plus drinking coffee beside hospital routine care. Instruments of the study: Three instruments were used for data collection Instrument I: Structured interview questionnaire. Instrument II: Grading of post dural puncture headache (PDPH) Severity (Campbell et al., 1993) Instrument III: The Instrument was adapted from Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq) (Mui et al., 2011). The main findings of the present study were • There was a highly statistical significant difference among control group and study group 1,2 regarding severity of headache after one week post-surgery. • There was a highly statistical significant relationship between control group and study group1 after one week post-surgery according to effect of headache on all activities on daily living. • There was a highly statistical significant relationship between control group and study group 2 after one week post-surgery according to effect of headache on all activities on daily living.• There was no statistical significant relationship between study group 1 and study group 2 after one week post-surgery according to effect of headache on all activities on daily living. Conclusion • Nursing intervention had a significant effect on PDPH among study group1 than control group. • Nursing intervention had a significant effect on PDPH among study group2 than control group. • Nursing intervention had a positive effect on patients ’ satisfaction with spinal anesthesia among both study group 1&2. Recommendations It is recommended to generalize these structured nursing measures in hospitals to be included in the routine post-operative nursing care for patients undergoing spinal anesthesia. This would decrease the incidence of complications, and reduce hospital length of stay. More research is needed to investigate the effectiveness of these measures in other types of surgery using spinal anesthesia. |