Effect of Altitude on Postdural Puncture Headache After Caesarean Delivery

NCT ID: NCT05804448

Last Updated: 2025-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

292 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-18

Study Completion Date

2026-04-20

Brief Summary

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The aim of this study is to examine the effects of altitude (high altitude versus low altitude) on incidence and severity of postural puncture headache (PDPH) following spinal anaesthesia for caesarean delivery. The investigators hypothesized that the risk of PDPH would be higher in highlander parturients than in lowlander parturients.

Detailed Description

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This will be a prospective cohort study conducted in two different altitudes in Nepal. The high-altitude site is in Jumla, approximately 2514 m above the sea level, and a low altitude city is Dharan, located at 350 m from sea level.

The investigators will screen the eligible participant admitted to the in-patient obstetric unit. The investigator will also record patient baseline characteristics, preoperative anxiety, antenatal depression, presence of chronic pain conditions or preexisting headache. Spinal anaesthesia will be administered in the sitting position at the L3-L4 or L4-L5 interspace using a 25-G pencil point spinal needle (Pencan® 25-gauge).

The diagnosis of post-dural puncture headache will be based on the international headache society ICDH-3 criteria

Conditions

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Post-Dural Puncture Headache

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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High-altitude group

Parturient who are native to their resident altitude, i.e. residing at the altitude above 2500 m from sea level will receive spinal anesthesia for caesarean section.

No interventions assigned to this group

Low-altitude group

Parturient who are native to their resident altitude, i.e. residing at the altitude below 500 m from sea level will receive spinal anesthesia for caesarean section.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Parturient, aged more than or equal to 18 years
* American society of Anesthesiologist 2 and 3
* Scheduled for elective and non-elective (category 2 \& 3) caesarean delivery with spinal anesthesia
* Native to their resident altitude i.e., those born, raised, and have continuously lived at the same altitude, at least for the past 1 year.

Exclusion Criteria

* Hypertensive disorder
* Cerebrovascular disease
* Mental disorder (schizophrenia and other psychotic disorders)
* Known fetal anomalies
* Contraindication to spinal anaesthesia.
* Those requiring general anaesthesia for delivery due to failed spinal anesthesia
* Major post-delivery complications (severe haemorrhage, sepsis, or ICU admission)
* Those who migrate from their resident altitude (either low to high or vice versa) within 7 days post-delivery will also be excluded.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Karnali Academy of Health Sciences

OTHER

Sponsor Role collaborator

B.P. Koirala Institute of Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Dr Asish Subedi

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Karnali Academy of Health Sciences

Jumla, Karnali, Nepal

Site Status RECRUITING

BP Koirala Institute of Health Sciences (BPKIHS)

Dharān, Koshi, Nepal

Site Status RECRUITING

Countries

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Nepal

Central Contacts

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Asish Subedi, MD

Role: CONTACT

9842040604

Facility Contacts

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Robin Khapung, MD

Role: primary

9849481562

Asish Subedi, MD

Role: primary

977-25-525555 ext. 2013

Other Identifiers

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533/2022 P

Identifier Type: -

Identifier Source: org_study_id

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