Post-Spinal Anesthesia Headache Prevention and Management: A Brief Literature Review

Post-spinal anesthesia headache (PSAH) is one of the most frequent complications following a subarachnoid puncture for anesthetic or diagnostic procedures.This painful condition is largely due to the leakage of cerebrospinal fluid (CSF) through the dural opening, leading to a drop in intracranial pressure and the typical presentation of pulsatile pain, which intensifies in an upright position and eases when lying down.In addition to headache, nausea, dizziness, and photophobia may occur, significantly impacting postoperative recovery, prolonging hospitalization, and straining the healthcare system.Prevention of PSAH involves the careful choice of needle gauge and type-preferably pencil-point needles with a smaller diameter-as well as technical care during the puncture, since cutting-tip needles of larger gauge increase the risk of extensive dural injury.Factors such as age, sex, the number of puncture attempts, and obstetric procedures (particularly in young women) also influence the incidence of headache.Regarding management, the initial approaches include conservative measures such as hydration, common analgesics (non-opioid analgesics or non-steroidal anti-inflammatory drugs), and relative bed rest.