Post-lumbar puncture headache: Difference between revisions
| Line 18: | Line 18: | ||
##Using smaller-bore needles | ##Using smaller-bore needles | ||
##Using atraumatic needles | ##Using atraumatic needles | ||
#Recumbency | #Recumbency and bedrest NOT effective | ||
==Source== | ==Source== | ||
Revision as of 21:29, 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[1]
- 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
- 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 and 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.