POST-DURAL PUNCTURE HEADACHE IN SPINAL ANESTHESIA: A LITERATURE REVIEW ON INCIDENCE, RISK FACTORS AND MANAGEMENT STRATEGIES
DOI:
https://doi.org/10.47820/recima21.v5i6.5321Keywords:
Postdural puncture headache. Spinal anesthesia. Incidence, risk factors. Management strategies.Abstract
Post dural puncture headache (PDPH) is a common and debilitating complication following spinal anesthesia, negatively impacting patient recovery and increasing healthcare costs. Objective: This literature review aims to address the incidence, risk factors and management strategies of PDPH in patients undergoing spinal anesthesia. Methods: This literature review was conducted through a systematic search of scientific literature published in the last 15 years, covering the period from 2009 to 2024, in the PubMed, Web of Science, Scopus and Google Scholar databases. The inclusion criteria were original studies and reviews, in English, Portuguese or Spanish, which investigated intervention strategies for PDPH. Case reports, editorials and studies focused on other medical conditions were excluded. Results and Discussion: The incidence of PDPH ranges from 0.1% to 36% and is influenced by the anesthetic technique and patient characteristics. Risk factors include age, female gender and pregnancy. The choice of smaller-gauge, pencil-point needles reduces the incidence of PDPH. Ultrasound-guided puncture techniques minimize traumatic punctures. Conservative management, including hydration and the use of analgesics, is effective in mild cases. Epidural blood patch is the gold standard treatment for severe cases, while caffeine derivatives are a promising alternative. Conclusion: This review highlights the importance of a multifaceted approach to the prevention and management of PDPH, integrating evidence-based practices, continuing education of healthcare professionals and ongoing research.
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