Perioperative headache and day case surgery.

BACKGROUND AND OBJECTIVE

Headache is a common and distressing morbidity associated with day case surgery. We undertook a prospective, observational study to identify risk factors associated with perioperative headache in a modern, day case surgery setting.

METHODS

Two hundred-and-thirty consecutive patients presenting for day case surgery were invited to complete a questionnaire about their previous experience of headache and various associated risk factors. Questionnaires were completed by 90% of patients. The presence of headache in the pre- or postoperative period was also documented. We used multivariate logistic regression to model perioperative headache.

RESULTS

Increased frequency of previous headache, odds ratio (95% confidence interval) 1.9 (1.2-2.8) (P = 0.004) and low alcohol consumption 0.90 (0.87-0.98) (P = 0.019) were significant predictors. A history of migraine showed a trend towards being predictive 1.9 (0.9-4.0) (P = 0.055). Some risk factors thought to be important such as caffeine withdrawal and duration of starvation and fluid deprivation were not associated with perioperative headache in this setting.

CONCLUSIONS

In this study of risk factors associated with perioperative headache in day case surgery, increased frequency of headache and low alcohol consumption were independent risk factors.