Post-lumbar puncture headache: Difference between revisions
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##500 mg (diluted in 1 L of NS) over one hour<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>, followed by 1 L of NS x 1 hour | |||
##Can give second dose in 4 hours if pain persists | |||
#Blood patch if above fails | #Blood patch if above fails | ||
Revision as of 21:27, 7 April 2014
Background
- 10-36% of pts develop HA within 24-48hrs post-LP
Clinical Features
- Worsening with upright position and relief with recumbency
Treatment
- Simple analgesics
- IV fluids
- IV caffeine
- 500 mg (diluted in 1 L of NS) over one hour[1], followed by 1 L of NS x 1 hour
- Can give second dose in 4 hours if pain persists
- Blood patch if above fails
Prevention
- Minimize risk by:
- Orienting needle bevel parallel to longitudinal fibers of dura
- Using smaller-bore needles
- Using atraumatic needles
- Recumbency, bedrest not effective
Source
Tintinalli
- ↑ 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.