Post-lumbar puncture headache - Revision history

Danbot: Add MedicationDose entry for caffeine

2026-03-20T21:21:19Z

Add MedicationDose entry for caffeine

@@ Line 31: / Line 31: @@
 **Stylet replacement before needle removal
 *Recumbency and bedrest NOT effective<ref>Arevalo-Rodriguez I, Ciapponi A, Roque I Figuls M, et al. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2016;3:CD009199.</ref>
 ==See Also==

2023-06-07T23:21:42Z

Background

← Older revision		Revision as of 23:21, 7 June 2023
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	==Background==		==Background==
	*10-36% of patients develop headache within 24-~~48hrs~~ post-[[LP]]		*Also known as a "post-dural puncture headache"
			*10-36% of patients develop headache within 24-48 hours post-[[LP]]
	*Due to persistent CSF leak		*Due to persistent CSF leak
	*Also known as "Postdural Puncture Headaches"
	*A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles<ref>Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review And Meta-Analysis Nath, S., et al, Lancet 391(10126):1197, March 24, 2018</ref>		*A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles<ref>Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review And Meta-Analysis Nath, S., et al, Lancet 391(10126):1197, March 24, 2018</ref>

2023-06-07T21:18:39Z

Prevention: added citation for no bed rest

← Older revision		Revision as of 21:18, 7 June 2023
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	**Using atraumatic needles		**Using atraumatic needles
	**Stylet replacement before needle removal		**Stylet replacement before needle removal
	*Recumbency and bedrest NOT effective		*Recumbency and bedrest NOT effective<ref>Arevalo-Rodriguez I, Ciapponi A, Roque I Figuls M, et al. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2016;3:CD009199.</ref>

	==See Also==		==See Also==

2022-12-19T16:48:32Z

Management

← Older revision		Revision as of 16:48, 19 December 2022
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	*Simple [[analgesia\|analgesics]]		*Simple [[analgesia\|analgesics]]
	*[[IV fluids]]		*[[IV fluids]]
			*PO [[caffeine]]<ref>Camann WR, Murray RS, Mushlin PS, Lambert DH. Effects of oral caffeine on postdural puncture headache. A double-blind, placebo-controlled trial. Anesth Analg. 1990 Feb;70(2):181-4. doi: 10.1213/00000539-199002000-00009. PMID: 2405733.</ref>
			**300mg PO x 1
	*IV [[caffeine]]<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>		*IV [[caffeine]]<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>
	**500mg (in 1 L of NS) over 1 hour, followed by 1 L of NS x 1 hour		**500mg (in 1 L of NS) over 1 hour, followed by 1 L of NS x 1 hour

2021-01-13T16:43:44Z

Background

← Older revision		Revision as of 16:43, 13 January 2021
Line 1:		Line 1:
	==Background==		==Background==
	*10-36% of patients develop headache within 24-48hrs post-[[LP]]		*10-36% of patients develop headache within 24-48hrs post-[[LP]]
			*Due to persistent CSF leak
	*Also known as "Postdural Puncture Headaches"		*Also known as "Postdural Puncture Headaches"
	*A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles<ref>Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review And Meta-Analysis Nath, S., et al, Lancet 391(10126):1197, March 24, 2018</ref>		*A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles<ref>Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review And Meta-Analysis Nath, S., et al, Lancet 391(10126):1197, March 24, 2018</ref>

2021-01-13T16:42:56Z

Prevention

← Older revision		Revision as of 16:42, 13 January 2021
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	*Minimize risk by:		*Minimize risk by:
	**Orienting needle bevel parallel to longitudinal fibers of dura		**Orienting needle bevel parallel to longitudinal fibers of dura
	**Using smaller-bore needles		**Using smaller-bore needles (22 gauge or smaller)
	**Using atraumatic needles		**Using atraumatic needles
			**Stylet replacement before needle removal
	*Recumbency and bedrest NOT effective		*Recumbency and bedrest NOT effective

2019-10-03T04:28:52Z

Management

← Older revision		Revision as of 04:28, 3 October 2019
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	==Management==		==Management==
	*Simple analgesics		*Simple [[analgesia\|analgesics]]
	*IV fluids		*[[IV fluids]]
	*IV caffeine<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>		*IV [[caffeine]]<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>
	**500mg (in 1 L of NS) over 1 hour, followed by 1 L of NS x 1 hour		**500mg (in 1 L of NS) over 1 hour, followed by 1 L of NS x 1 hour
	**Give second dose in 4 hours if pain persists		**Give second dose in 4 hours if pain persists

2019-01-08T23:39:58Z

← Older revision		Revision as of 23:39, 8 January 2019
Line 27:		Line 27:
	**Using atraumatic needles		**Using atraumatic needles
	*Recumbency and bedrest NOT effective		*Recumbency and bedrest NOT effective

			==See Also==
			*[[Lumbar Puncture]]

	==References==		==References==

2019-01-08T23:38:48Z

Background

← Older revision		Revision as of 23:38, 8 January 2019
Line 2:		Line 2:
	*10-36% of patients develop headache within 24-48hrs post-[[LP]]		*10-36% of patients develop headache within 24-48hrs post-[[LP]]
	*Also known as "Postdural Puncture Headaches"		*Also known as "Postdural Puncture Headaches"
			*A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles<ref>Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review And Meta-Analysis Nath, S., et al, Lancet 391(10126):1197, March 24, 2018</ref>

	==Clinical Features==		==Clinical Features==

2017-03-01T16:36:56Z

← Older revision		Revision as of 16:36, 1 March 2017
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	*IV fluids		*IV fluids
	*IV caffeine<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>		*IV caffeine<ref>Yücel A, Ozyalçin S, Talu GK, et al. Intravenous administration of caffeine sodium benzoate for postdural puncture headache. Reg Anesth Pain Med 1999; 24:51.</ref>
	**500mg (in 1 ~~left~~ of NS) over 1 hour, followed by 1 ~~left~~ of NS x 1 hour		**500mg (in 1 L of NS) over 1 hour, followed by 1 L of NS x 1 hour
	**Give second dose in 4 hours if pain persists		**Give second dose in 4 hours if pain persists
	*Blood patch if above fails		*Blood patch if above fails