The same approach to treating headaches after a dural puncture needle is used to treat headaches after spinal anesthesia includes:

1. Sedation, bed rest and rehydration 80%~85% of patients with headache after spinal anesthesia can recover within 5 days. The purpose of rehydration is to increase the amount of cerebrospinal fluid so that the amount of cerebrospinal fluid produced exceeds the amount of leakage, and the pressure of cerebrospinal fluid can gradually return to normal. According to reports, 50% of patients with headache after spinal anesthesia have mild symptoms that do not affect their daily life, 35% have discomfort and need bed rest, and 15% have severe symptoms and can't even sit up to eat.

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 is a cerebral vasoconstrictor drug that can be used to treat headache after spinal anesthesia. Add 500 mg of caffeine to 1000 ml of lactated Ringer's solution for intravenous infusion, 80% of patients can improve symptoms, and oral 300 mg of caffeine can also improve symptoms.

3. Epidural saline infusion Epidural saline infusion can also be used to treat headaches after spinal anesthesia. A single injection of saline cannot maintain a high epidural pressure to prevent cerebrospinal fluid leakage. Large doses are required ( At least 24 hours infusion, 15~25ml/h) is effective.

4. Epidural blood patch If the above conservative treatment is still ineffective after 24 hours, epidural blood patch therapy can be used. The puncture hole in the meninges is sealed by filling the epidural with blood to prevent the leakage of cerebrospinal fluid. The needle is placed in the epidural space near the original puncture site, and 10ml to 20ml of autologous blood is aseptically injected. This method has an effective rate of 90% to 95%. If the pain does not subside after 24 hours, it can be used repeatedly. If it is still ineffective after 2 treatments, the diagnosis should be reconsidered. Epidural blood filling may cause discomfort such as back pain, but serious complications associated with it have not been reported.

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