Question

What should be done if woman complains of a headache that is worse when she is in an upright position after Subarachnoid (spinal) block?

Answer 1

If a woman complains of a worsened headache in an upright position after a spinal block, it may be post-dural puncture headache (PDPH). Treatment options for PDPH include bed rest, hydration, pain relievers, and in some cases, an epidural blood patch.

Step-by-step explanation:

If a woman complains of a headache that is worse when she is in an upright position after a subarachnoid (spinal) block, it could be a sign of a condition called post-dural puncture headache (PDPH). PDPH is a common complication of spinal anesthesia, and it occurs when the dura, the outermost layer of the spinal cord, is punctured during the procedure. This can cause cerebrospinal fluid (CSF) leakage, which leads to a decrease in CSF pressure and triggers the headache.

To manage PDPH, several conservative treatment options can be used. These include:

1. Bed rest: Resting in a supine position (lying flat) can help alleviate the headache as it reduces the pressure on the spinal cord.
2. Hydration: Drinking plenty of fluids can help maintain adequate CSF volume and pressure.
3. Pain relievers: Over-the-counter pain medications like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) may provide temporary relief from the headache.
4. Epidural blood patch: If conservative measures fail to improve the symptoms, an epidural blood patch may be performed. This involves injecting the patient's own blood into the epidural space to seal the hole and restore CSF pressure.