Post - Spinal Anesthesia Headache Treatment: a literature review

Abstract

Background: Post-spinal anesthesia headache is a common complication of this procedure due to the loss of cerebrospinal fluid through the puncture orifice. Resolution may be spontaneous or require interventions such as presented in this study. Objective: To address the most relevant and current aspects of post-spinal anesthesia headache treatment. Methods: Literature review based on Pubmed, Scielo and Google Scholar databases, having as inclusion criteria articles of great published in English, Portuguese and Spanish in the period 2016 to 2021 and exclusion criteria articles published outside that period. Results: Post-spinal anesthesia headache or post-dural puncture headache (DPC) is divided into disabling headache and non-disabling headache in order to guide its management. In non-disabling headache, analgesics, caffeine and hydration are used. In disabling headache, blood-patching can be performed from the injection of autologous blood in the epidural space in order to buffer the puncture hole. In addition to this technique, there is the blockade of the sphenuous- palatine ganglion, which is performed by applying 5% lidocaine with the aid of a swab, introduced perpendicularly to the nasopharynx, where the sphenuous ganglion is located – palatine ,inhibiting vasodilation from the blockage of parasympathetic transmission and thus decreasing the intensity of headache, considering the approachless invasive and with fewer complications, but that needs to be better studied for its application. Conclusion: The treatment of mistraining cppd from conservative to more invasive procedures and with a higher risk of complications. Due to the above, studies should be encouraged to expand the therapeutic arsenal of this disabling headache.