Headaches after spinal anesthesia are not uncommon. They occur in thirty percent of cases and last from several hours to a day. They may persist longer, but such a complication occurs less frequently - only one percent of all operations performed under this type of anesthesia.
To understand why you get a headache after spinal anesthesia, you need to first talk about what spinal anesthesia is and how it is carried out.
Spinal anesthesia is a method of spectrum regional anesthesia. Its effect extends to the lower half of the body, completely blocking any sensitivity below the waist. It is most often used during caesarean section surgery, as well as for knee replacements and other interventions that affect the lower limbs and abdominal cavity.
Spinal anesthesia is performed by puncture with a thin needle, through which a medicine is introduced into the body that blocks the nerve endings responsible for transmitting information about pain sensations to the brain center. The needle passes through the vertebrae into the subarachnoid space, after which a dose of anesthetic is injected into the body, and the needle is removed. The consequences of spinal anesthesia include the fact that the patient feels pain and feels dizzy.
How to avoid headaches and nausea after spinal anesthesia
The amount of cerebrospinal fluid released directly depends on the size of the puncture. Therefore, it is logical to assume that the best way to avoid headaches after a spinal injection would be to use a needle of a thinner diameter. And so it is, and, moreover, such needles exist and are successfully used. Special needles for spinal anesthesia have a smaller diameter and a special “pencil” sharpening method. Unfortunately, such needles are very expensive and therefore rarely used in our country. In Russia, “old” needles that have a conical sharpening and a fairly large diameter are still common, and this is the reason that many people continue to complain of headaches after spinal anesthesia.
How to prevent headaches after anesthesia
The degree of risk of developing complications largely depends on the qualifications of the anesthesiologist and other medical personnel. High-quality materials, specialized training and adherence to the technique of performing the procedure reduce the likelihood of adverse reactions to a minimum.
An equally important point is compliance with all recommendations by the patient himself.
Methods for preventing headaches after spinal anesthesia:
- special preparation for the procedure - if possible, 7-8 hours before the procedure, you should stop eating and smoking, and limit the amount of liquid you drink. The patient benefits from adequate sleep and walks in the fresh air;
- correct positioning of the body - to carry out the manipulation, a person can be laid on his side, but it is better if he is in a sitting position with his back tilted forward as much as possible. Another mandatory requirement is patient immobility;
- the use of specialized needles - the tool should be small with a “pencil” type of sharpening. The hole is minimal; liquor does not flow out through it;
- observance of a special regime after the session - bed rest is recommended for those who have undergone spinal anesthesia. It is necessary to ensure that the patient’s head does not hang down or rise. Additionally, it is recommended to drink at least 2-3 liters of liquid.
The appearance of a headache after anesthesia while observing the above points may indicate the presence of hidden pathologies in a person or a medical error. In any case, the fight against manifestation should be specialized. Attempts to limit yourself to taking medications alone do not always give the desired result.
What to do when you have a headache after spinal anesthesia
On the first day after the use of spinal anesthesia, doctors recommend that in order to reduce discomfort, stay in a horizontal position as much as possible and drink enough fluid, at least two liters. If the question arises of how to relieve severe headaches after spinal anesthesia with the help of medications, let’s take painkillers such as paracetamol, citramon. Caffeine has a good effect. By the way, it is precisely because of the caffeine content that drinks such as tea, coffee and Coca-Cola relieve the condition.
What is spinal anesthesia
Spinal anesthesia is a type of local anesthesia. Its purpose is to turn off the nerve endings that innervate the lower half of the body. This occurs due to a disruption in the exchange of signals between the brain and spinal cord. Painkillers are injected directly into the spinal space of the spine. A small volume of cerebrospinal fluid is first removed from it so that pressure does not increase. To manipulate and puncture the dura mater, a specialist uses a special needle. He inserts it into the area between the vertebrae at the junction of the lower back and the back.
The procedure is performed or supervised by an anesthesiologist. If everything is done correctly, the approach will not only neutralize pain, but will also reduce the likelihood of bleeding during the operation. Due to these properties, local administration of an anesthetic is indicated for caesarean section, gynecological and urological interventions, and procedures in the back, pelvis, and lower extremities. If the patient has a headache after post-spinal anesthesia, this indicates a violation of the technique of performing the manipulation.
Treatment of headache after spinal anesthesia
When you have a headache after spinal anesthesia, the first measure to eliminate it is complete bed rest. You need to get up as little as possible and, if possible, do without a pillow. We have already mentioned drinking plenty of fluids and using medications. But what will be the treatment for headaches after spinal anesthesia if the migraine persists on the second and third days?
To stop it, a method called “blood patch” is used. The procedure is performed, again, by an anesthesiologist. To install a “blood patch,” blood is taken from the patient’s vein and injected into the exact area where a puncture was previously performed for spinal anesthesia. The blood, due to its natural properties, coagulates and completely clogs the hole through which the cerebrospinal fluid flows. The headache after installing such a “patch” usually goes away within 24 hours. If this does not happen, the manipulation is performed again, which already gives a one hundred percent guarantee of a positive result. Unfortunately, the method is not safe; it is fraught with infection, bleeding, and impaired sensitivity of the lower extremities.
As an alternative to blood, some specialists use saline solution. On the one hand, it is much more sterile, and the risk of side effects is correspondingly lower, but at the same time, the saline solution is perfectly absorbed, so the “patch” effect may not work.
Features of epidural anesthesia
Epidural anesthesia differs from spinal anesthesia in the technique of administration. The anesthetic is injected into the epidural, cellular space, anesthetizing the nerve endings. In the case of spinal - into the subarachnoid, with overcoming the hard shell. The time period before the action begins varies. The epidural works in twenty minutes, the spinal in five. The technique of execution is different.
| Technical details | Epidural anesthesia | Spinal anesthesia |
| Tools | Thick needle for puncture. | Thin needle with a “pencil” sharpening. |
| Place of puncture |
| Between the 2nd and 3rd lumbar vertebrae. |
| Depth | Does not affect the spinal canal. | Directly injected into the spinal space, after preliminary withdrawal of 3-4 ml of cerebrospinal fluid. |
Interesting: Can contact lenses cause headaches?
The technique is similar; the manipulation is performed by an anesthesiologist. The patient is either on his side in the “fetal position” or sitting with his knees pulled up to his chest. Epidural anesthesia is less traumatic than spinal anesthesia. Headaches occur less frequently after epidural anesthesia, in only one percent of cases, but the pain syndrome is longer and more intense.
Risk group and possible causes
Headache appears after different types of anesthesia, it can be local and general, and both methods of pain relief have different effects on the body.
Doctors believe that almost everyone has a headache after surgery and this is normal. A pathological process will occur if headaches after surgery do not go away on their own within a couple of weeks.
Statistics show that females experience attacks more often after surgery.
The risk of pain after anesthesia increases with each year of life and the older the person, the more likely this side effect is.
Pain also occurs in people who undergo frequent surgery.
The main reasons why headaches appear after anesthesia are:
- Dehydration.
- The impact of the anesthesia itself, or rather the substances that are used.
- Low pressure.
- Attacks of cephalalgia, which appeared frequently before the operation.
- Low body weight of the patient.
- Diseases of the endocrine group.
- Stressful situations before surgery.
In almost half of the cases, the use of anesthesia is accompanied by headaches.
As a rule, the headache does not occur on its own, but is accompanied by other unpleasant symptoms; dizziness is possible, especially with a sudden change in the body.
Headaches are aching in nature and can rarely be sharp. They are localized on the entire upper part of the head, and in some sides they can be on the left or right side, in different areas.
Your head may hurt more if you move actively, bend over, or listen to loud music.
After some time, a person may develop cephalgia, in which case the headaches intensify and may be accompanied by nausea, followed by vomiting.
The condition is very unpleasant and cannot be eliminated with conventional antispasmodic drugs. It will take time and other medications to stop the attack.
Side effects of anesthesia
Patients often complain that after anesthesia a headache begins. Women who have given birth also complain of pain after epidural anesthesia during caesarean section. In addition to headaches, other symptoms are also troubling, each of which requires special treatment.
Of all the body's reactions to anesthesia, patients are most often bothered by the following symptoms:
- pain in the area where the needle was inserted;
- prolonged nausea accompanied by dry mouth (vomiting occurs rarely);
- regular dizziness (occasionally ending in fainting);
- decreased blood pressure;
- the neck loses mobility and hurts (especially after spinal anesthesia);
- rare pulse;
- weakness, fatigue, decreased physical activity;
- discomfort (itching, burning) in the spine;
- the appearance of red spots on the head under the hair;
- decreased sensitivity of the lower extremities.
For 2-4 hours, the anesthesiologist monitors the patient’s general condition. If side effects appear 1-2 days after surgery, be sure to inform your doctor about the body’s alarm signals.
Types of pain relief
Before the operation, the anesthesiologist, taking into account all the characteristics of the body and past diseases, selects the type of anesthesia. There are several types of pain relief:
- Epidural anesthesia. This is the introduction of an anesthetic fluid into the epidural space of the spine without damaging the dura mater of the spinal cord. The occurrence of headaches after anesthesia is excluded. Spinal anesthesia is used, for example, during childbirth.
- General anesthesia. A complete loss of consciousness occurs; if necessary, a special tube is inserted into the trachea for breathing. There is no pain or discomfort at all.
- Spinal anesthesia. The use of spinal anesthesia is recommended if necessary to numb the lower part of the body (lower limbs, pelvic organs). The needle is inserted into the lumbar region, through the hard shell of the spinal cord, and part of the cerebrospinal fluid is removed. The injection is made into the subarachnoid space.
With any type of anesthesia, much depends on the professionalism of the anesthesiologist - preparation for the operation should be carried out by an experienced doctor.
