Anesthésie et recherche clinique
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Beware while Treating Post-Spinal Headache!

Sadhana Sudhir Kulkarni*, Savani Sameer Futane

Central Neural Block (CNB) is administered frequently for caesarean section. Post-spinal Headache (PSH) is the most frequent and discomforting late complication of spinal anesthesia. PSH is an important cause of iatrogenic maternal co-morbidity and maternal dissatisfaction. Expedited discharge of the mother or delayed onset of PSH in some women may not capture all the mothers developing PSH after hospital discharge. The mother having PSH might first report to the obstetrician. A pilot study in our institute, regarding knowledge and practice of treatment of PSH amongst obstetricians demonstrated limited knowledge of PSH. Even though PSH is a self-limiting condition, a subset of patients will suffer from potentially life-threatening neurological consequences. Such a patient needs urgent referral to an anesthesiologist, neurologist and special radiological investigations for definitive diagnosis and treatment. Awareness needs to be there amongst obstetricians regarding PSH to avoid medico legal problems and patients also are to be educated about red flag symptoms once they develop PSH.

This article reviews the pathophysiology, clinical picture and management of PSH with special considerations during the postpartum period.