What should I do if I have a headache after lumbar puncture?

There are currently mixed opinions on the use of analgesics for postoperative headaches. Non-opioid analgesics, such as non-steroidal anti-inflammatory drugs, are recommended by some scholars as the first choice for postoperative headache pain. If the above drugs don't work, acetaminophen and less potent opioids can come in handy. It is worth noting that the evidence for recommending the use of opioids is not strong and should be used with caution in clinical practice.

In addition, there is also evidence that oral gabapentin, oral theophylline, and intravenous hydrocortisone reduce pain scores, while subcutaneous sumatriptan does not. There are clinical trial results suggesting that caffeine can be used as a treatment for postoperative headache, but due to the small sample size of these trials and the inconsistent results of different trials.

And some scholars pointed out that the dose of caffeine in the treatment of postoperative headache has central nervous system toxicity, and has a certain relationship with atrial fibrillation. Therefore, there is no consensus on whether caffeine should be used as a routine medication for postoperative headache relief. The use of these drugs should be analyzed and used according to the specific situation of the patient, such as the assessment of the patient's age, weight and respiratory disease. If drug treatment is ineffective, epidural injection of normal saline can promote the healing of puncture wounds through the clump effect. The epidural blood patch therapy may be the last magic weapon for the treatment of refractory postoperative headache after lumbar puncture, even if the current opinions on the method are not unified.

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