Anesthésie et recherche clinique
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Effect of Pre and Post Nursing Intervention on the Occurrence of Tension Headache among Surgical Patients Undergoing Spinal Anesthesia

Zeinab Hussain Ali

Spinal anesthesia is a frequently performed procedure in medical emergencies and anesthesia. Tension headache after lumbar puncture is a common occurrence (32%) and carries a considerable morbidity, with symptoms lasting for several days, at times severe enough to immobilize. The aim of this study is to assess the effect of pre and post nursing intervention on the occurrence of tension headache among surgical patients undergoing spinal anesthesia. This quasi-experimental study was conducted in El-Naser Health Insurance Hospital; in Helwan city in Egypt, 60 adult patients admitted for lower abdominal surgery using spinal anesthesia were recruited. The only exclusion criterion was pregnancy in female patients. Participants were alternatively assigned to either the intervention or control groups, ending with 30 patients in each group. The data collection tools consisted of two tools. Tool 1 was concerned with characterization of the pain and patient’s personal data. The second tool was a visual analog scale (VAS). The researchers designed a structured pre-spinal anesthetic nursing intervention to be applied to the study group. Control group received the routine nursing intervention only. The results revealed that the incidence of tensions headache became significantly lower in the study group, reaching its lowest rate (3.3%) by the end of the third day, compared to 76.7% in the control group (p<0.001) the mean duration of tension headache was shorter in the study (22.1 ± 34.0 hours) than in the control (111.2 ± 55.9 hours) group, p<0.001 as well patients in the study and control groups also demonstrated statistically significant differences in the experience of symptoms associated with tension headache (p < 0.001). In conclusion, the structured nursing measures before and after the procedure
was successful in decreasing the incidence and duration of this tension headache and its associated symptoms. Therefore, it is recommended to generalize these structured nursing measures in hospitals to be included in the routine pre-operative and post-operative nursing care for patients undergoing lower abdominal surgery with spinal anesthesia.