Post-spinal headache, also known as post-spinal anesthesia headache, is a type of headache that appears a few hours or days after administration of the anesthetic and can disappear spontaneously within 2 weeks. In this type of headache, the pain is more intense when the person is standing or sitting and improves soon after the person lies down.
Despite being uncomfortable, post-spinal headache is considered a complication due to the technique used in the procedure, being reported by some people who have undergone this type of anesthesia, and passes after a few weeks of supportive treatment, with the use of medicines that help relieve pain faster.
Main symptoms
The main symptom of post-spinal headache is, in fact, headache, which can appear up to 5 days after the administration of anesthesia, being more common to appear after approximately 24 to 48 hours. The headache usually affects the frontal and occipital region, which corresponds to the back of the head, and can also extend to the cervical region and shoulders.
This type of headache usually worsens when the person sits or stands and improves when lying down and can be accompanied by other symptoms such as neck stiffness, nausea, greater sensitivity to light, tinnitus and decreased hearing capacity.
Causes of post-spinal headache
The cause that leads to headache after spinal anesthesia is not yet very well understood, however it has been explained according to theories, the main one being that at the moment the puncture is made in the place where the anesthesia is applied, there is extravasation of cerebrospinal fluid, the CSF, reducing pressure in the area and promoting a shift in the brain structures related to pain sensitivity, resulting in headache, in addition to the loss of CSF being greater than its production, there is an imbalance.
Furthermore, some studies report that there are some factors that may favor the development of post-spinal headache, such as the use of large-caliber needles, repeated attempts at anesthesia, the person’s age and gender, level of hydration, leakage of a large amount of CSF. at the time of puncture and pregnancy.
How the treatment is carried out
The headache after spinal anesthesia usually disappears after a few weeks, however it is recommended that the person drinks plenty of fluids to help relieve it faster. In addition, it may be recommended to use medications that help relieve headaches and other symptoms that may be associated.
When hydration and the use of medicines recommended by the doctor are not enough, epidural blood tamponade, also known as blood patch. In this case, 15 ml of blood is collected from the person and then punctured in the place where the first puncture was made. Some studies indicate that through this technique it is possible to temporarily increase epidural pressure, helping to combat headaches.
Bibliography
- Rodrigo Nigri de Oliveira; Ana Paula Grachten; Jose Antonio Vives Vinhas Filho. Post-spinal anesthesia headache. VHL Publications. 2018. Available at: <http://docs.bvsalud.org/biblioref/2018/04/882562/cefaleia-pos-raquianestesia.pdf>.
- FEDERAL UNIVERSITY OF CEARÁ – MATERNITY SCHOOL ASSIS CHATEUBRIAND. Post-spinal anesthesia headache. 2016. Available at: <http://www2.ebserh.gov.br/documents/214336/1106060/Cap%C3%ADtulo-3-CEFALEIA-P%C3%93S-RAQUIANESTESIA-rev.pdf/50ffe9c1-deb2- 482b-87d0-4f2c4cf47359>. Accessed on 04 Jun 2020
- BARBOSA, Fabiano T. Headache after Subarachnoid Anesthesia with Seven Months of Evolution: Case Report. Rev Bras Anestesiol. Vol 61. 3 ed; 355-359, 2011
- HERBELE, Andrey Gustavo et al. Post-spinal anesthesia headache treated with epidural blood patch: epidemiological analysis. Brazilian Journal of Neurology and Psychiatry. Vol 19. 2 ed; 118-129, 2015
