A major concern for women when they find out they are pregnant is about childbirth. Some spend nine months filled with anxiety, fear, and total insecurity about the unknown, trying to imagine what this moment will be like. Others, who are more secure and decided about what they want, do not think much about the moment, choosing to experience it only when the time comes. However, if the woman is informed about the subject and about certain precautions during cesarean section, for example, many discomforts such as post-spinal headache can be avoided.
Post-spinal headache or post-spinal anesthesia headache1, as it is also called by doctors, occurs in some cases after a cesarean section due to a drop in intracranial pressure, which is known as cerebrospinal fluid hypotension. As spinal anesthesia is used for cesarean section, as well as in other surgeries such as curettage, vascular, urologic, and other gynecological surgeries, it is important to be aware of certain symptoms afterwards, which are considered normal within a few hours after the procedure2.
Many people believe they develop the problem of headaches and severe migraines after undergoing a surgery where spinal anesthesia was used, but studies have shown that the pain from post-spinal headache is completely different from the usual headaches a person experiences throughout their life. And the main difference can even be noticed in posture, because the post-spinal headache disappears completely as soon as the woman lies down and returns instantly when she sits or stands up, unlike conventional headaches which can persist even when lying down. The pain usually appears at the front and back of the head as intense pressure.
Why Does It Happen and What Is the Treatment for Post-Spinal Headache?
During the administration of spinal anesthesia, a needle is inserted into the meninges where an analgesic is injected into the subarachnoid space, directly into the cerebrospinal fluid. This instantly blocks the nervous system and causes loss of movement and sensation in the lower part of the body, so that from the waist down, the patient feels absolutely nothing. Studies indicate that the main causes of post-spinal headaches are related to the thickness or gauge of the needle used to administer the anesthesia and the age of the woman undergoing the procedure. The rates are higher in younger women and also depend on the experience of the anesthesiologist.
If you already have a surgical procedure or cesarean section scheduled, be sure to make an appointment with the anesthesiologist and clarify all your doubts about before and after care, preparation, and possible post-procedure symptoms. This will give you peace of mind and information about the precautions, risks, and how they can be avoided. It is worth mentioning that the risk of toxicity from the use of spinal anesthesia is almost zero, but you may experience mild respiratory difficulty after the anesthesia, which is easily managed by the medical team.
After the surgery is completed, some precautions are recommended precisely to reduce the risk of post-spinal headache or even to prevent other discomforts and complications. The doctor will instruct you not to try to get up, move, or lift your head for a few hours, during which the patient will stay in a recovery room under observation until the anesthesia begins to wear off and sensation returns. Some women feel a strong urge to urinate during recovery and, since they cannot get up, the issue is resolved with a small catheter that empties the bladder painlessly and, believe me, brings great relief.
Treatment for post-spinal headache is simple and depends solely on the patient. In addition to using common painkillers such as paracetamol, rest is essential. The patient should get complete bed rest and avoid getting up, stretching, and moving around too much; drinking plenty of fluids will help with recovery and improvement. In 98% of cases, this treatment is fully effective3. If the condition persists, the doctor should be consulted for evaluation and to suggest alternative treatment. In some cases, an epidural blood patch may be recommended, where blood is drawn from the arm and injected into the area where the spinal anesthesia was administered, filling the space left by the anesthesia. The procedure takes around 20 to 30 minutes and resolves the problem promptly.
See also: Spinal Anesthesia – Debunking the Myths
