Caesarean section is a surgical technique to deliver a fetus through an incision in the abdominal wall and uterus. According to data from the WHO (World Health Organization), in 2010 the average cesarean section was around 5-15% per 1000 births in the world. The incidence of cesarean section in Indonesia has a rate of approximately 6.8% per 1000 births. Cesarean section is certainly inseparable from anesthesia. Generally, a cesarean section is performed using a regional anesthetic technique. Spinal anesthesia (subarachnoid block) is the preferred choice for cesarean section. The most common complication that occurs is Post Dural Puncture Headache (PDPH) or post-spinal anesthesia headache which can be caused by CSF leakage (Liquor Cerebra Spinal) due to spinal tissue injection. Objective: To determine the comparison of the incidence of post-dural puncture headache in section cesarean patients with spinal anesthesia using spinocan 25G and spinocan 27G at RSUP H. Adam Malik Medan and University Hospital of North Sumatra. Methods: The research design used in this study was a clinical trial using a double-blind randomized method carried out for 3 months, namely in August-October 2020 at the Central Surgical Installation of the Adam Malik Center General Hospital Medan and the University Hospital of North Sumatra. The sample obtained in this study amounted to 58 people according to the calculation of the number of samples, inclusion and exclusion criteria, which were then divided into 2 groups, namely 29 people in group A (spinocan 25G) and 29 people in group B (spinocan 27G). Results: The incidence of PDPH in cesarean section patients with spinal anesthesia was greater in the group using spinocan 25G than using spinocan 27G, which had a significant difference, especially at 24 hours and 48 hours (p <0.05). Conclusion: There is a significant difference in the incidence of PDPH in cesarean section patients at 24 hours and 48 hours

Keywords : PDPH, Caesarean Section, Anesthesia, Spinal, SpinocanKeywords: Hamilton Anxiety Rating Scale, Alprazolam , Anxietas