ArticleCureus2025
A Hospital-Based Quality Improvement Initiative to Reduce Postdural Puncture Headache in Cesarean Deliveries.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
Funding
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Abstract
backgroundPostdural puncture headache (PDPH) is a major complication of neuraxial anesthesia in cesarean deliveries. This study aimed to reduce PDPH incidence through a quality improvement initiative focusing on operating room (OR) efficiency and anesthetic management.
methodsUsing Plan-Do-Study-Act (PDSA) cycles, interventions included preoperative catheterization, synchronized scrubbing, and improved surgeon-anesthetist coordination. Spinal anesthesia protocols were refined with atraumatic needle techniques and standardized vasopressor use. Data from the pre-intervention (April to October 2023) and post-intervention (November 2023 to April 2024) periods were compared.
resultsOR time decreased from 105 to 85 minutes. PDPH incidence dropped from 16% (21/140 lower segment cesarean sections (LSCS)) to 1.5% (2/127 LSCS). Vasopressor use declined, with ephedrine doses reducing from 17 mg to 6 mg and phenylephrine from 30 mcg to 5 mcg, improving hemodynamic stability.
conclusionWorkflow enhancements effectively reduced PDPH incidence by optimizing OR efficiency and anesthetic management. Iterative PDSA cycles and real-time feedback contributed to sustained improvements, offering a scalable model for cesarean delivery quality improvement.
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