{
    "abstract": "\u00a0Postdural 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.\n\u00a0Using 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.\n\u00a0OR 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.\n\u00a0Workflow 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.",
    "authors": [
        {
            "affiliation": "Anesthesiology, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Fadlalraham",
            "initials": "F",
            "lastname": "Abdelrahim Hassan"
        },
        {
            "affiliation": "Medical Administration, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Ali Hadi M",
            "initials": "AHM",
            "lastname": "Alhajri"
        },
        {
            "affiliation": "Anesthesiology, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Mohammed",
            "initials": "M",
            "lastname": "Shoaib"
        },
        {
            "affiliation": "Obstetrics and Gynaecology, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Nisrin Magboul",
            "initials": "NM",
            "lastname": "Elfadel Magboul"
        },
        {
            "affiliation": "Obstetrics and Gynaecology, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Nedra Naser",
            "initials": "NN",
            "lastname": "Akremi Hammedi"
        },
        {
            "affiliation": "Obstetrics and Gynaecology, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Larcy",
            "initials": "L",
            "lastname": "Nice"
        },
        {
            "affiliation": "Operating Room, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Margie",
            "initials": "M",
            "lastname": "Asistin"
        },
        {
            "affiliation": "Infectious Diseases, Najran Armed Forces Hospital, Ministry of Defense Healthcare Services, Najran, SAU.",
            "firstname": "Vanessa",
            "initials": "V",
            "lastname": "Demata"
        }
    ],
    "conclusions": "\u00a0Workflow 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.",
    "copyrights": "Copyright \u00a9 2025, Abdelrahim Hassan et al.",
    "doi": "10.7759/cureus.79159",
    "journal": "Cureus",
    "keywords": [
        "anesthesia management",
        "cesarean delivery",
        "epidural blood patch",
        "post-dural puncture headache (pdph)",
        "quality improvement"
    ],
    "methods": null,
    "publication_date": "2025-03-20",
    "pubmed_id": "40109817\n28388808\n20533959\n7572008\n22287846\n20807248\n39255553\n17956576\n26950232\n31522933\n32997283\n34739134\n38137518\n39306572\n33882752\n37887695\n28367283\n37932915\n18559083",
    "results": "\u00a0OR 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.",
    "title": "A Hospital-Based Quality Improvement Initiative to Reduce Postdural Puncture Headache in Cesarean Deliveries.",
    "xml": "<Element 'PubmedArticle' at 0x788503047560>"
}