After anesthesia, the cerebrospinal fluid leaks from the puncture hole. Why does it cause headaches?

After anesthesia, the cerebrospinal fluid leaked from the puncture hole and caused the damage of the dural arachnoid membrane and caused headache. Measures to treat headaches after spinal anesthesia include:

1. Sedation, bed rest and fluid rehydration 80%~85% of headache patients after spinal anesthesia can heal spontaneously within 5 days. The purpose of rehydration is to increase the amount of cerebrospinal fluid so that it produces more than the amount of leakage, and the pressure of cerebrospinal fluid can gradually return to normal.

2. Intravenous or oral caffeine. Headache after spinal anesthesia is the result of the body's compensatory expansion of intracranial blood vessels in order to restore intracranial volume. Caffeine can be used to treat headaches after spinal anesthesia because of cerebral vasoconstrictors. Adding 500 mg of caffeine to 1000 ml of lactated Ringer's solution for intravenous infusion can improve symptoms in 80% of patients, and oral administration of 300 mg of caffeine can also improve symptoms.

3. Epidural filling blood After the above conservative treatment is still ineffective after 24 hours, epidural filling blood therapy can be used. Blood is filled through the epidural to seal the puncture hole of the spinal membrane and prevent the leakage of cerebrospinal fluid. Place the needle in the epidural space near the original puncture point, and inject 10ml-20ml of autologous blood aseptically. This method has an effective rate of 90%-95%. If the pain is not relieved after 24 hours, it can be used repeatedly. If it is still ineffective after two treatments, the diagnosis should be reconsidered.

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