Post lumbar puncture headache after varicose veins surgery

Headache is a complication of lumbar puncture that has been known for more than a hundred years. Post-dural puncture headache (PDPH) is characterized by the occurrence of a headache with a significant orthostatic component within 5 days of a lumbar puncture.

Patients after varicose vein surgery would like to go home on the same day or next day after surgery. But Varicose veins are generally operated under spinal anesthesia and if they develop head ache after surgery, their hospital stay gets prolonged . The incidence of head ache depends on a number of factors. Younger women with a previous history of headaches appear to be at highest risk. The incidence can be significantly reduced by using a thin lumbar puncture needle with an atraumatic tip. The condition is self-limiting and harmless, but leads to significant morbidity. Caffeine alleviates the symptoms and reduces the course of the illness. When bed rest and caffeine prove ineffective, an epidural blood patch works well for the majority, but there is no consensus on when such treatment should be offered. Headache frequently occurs after lumbar puncture for anesthesia in our hospitals. It is better to inform the patients about the same before surgery, so that their apprehensions can be relieved.  There is substantial evidence for recommending the use of a thin, atraumatic needle to reduce the incidence.