Treatment of diseases through surgery is stressful for the whole body. The operation is performed under anesthesia, which often causes a number of side effects.
In some cases, a headache begins to ache after anesthesia (narcosis). It happens that this alarming sign is not paid attention to, patiently waiting for everything to go away on its own.
This symptom should not be treated with disdain - after anesthesia, a headache can occur for several reasons, each of which requires urgent action. What factors cause headaches, what remedies will cope with the side effect, in what cases should you sound the alarm and immediately go to the doctor?
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.
Why does my head hurt after anesthesia?
The anesthesiologist punctures the hard shell of the spinal cord with a thin needle. In the space between the membrane and the brain stem there is a fluid that protects the brain tissue from damage. In the event of a puncture, cerebrospinal fluid may begin to leak. In this case, the patient’s intracranial pressure drops and a headache occurs. The longer the outflow of cerebrospinal fluid continues, the worse the headache.
To minimize the risk of complications and avoid leakage of cerebrospinal fluid, very thin needles sharpened using a special “pencil” method are used for the procedure. It is not always possible to eliminate headaches after anesthesia if the puncture is not performed at the desired angle, the needle has shifted, or the puncture hole has not been closed. Incorrect anesthesia technique leads to subarachnoid hemorrhage. There are even patients for whom spinal anesthesia does not help; they still feel pain from contractions or the incision.
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.
Clinical picture
The head begins to hurt 1-2 days after anesthesia. This is a pressing or throbbing pain with symmetrical localization. It intensifies when the head moves or the person takes a vertical position. Lasts on average from 2 to 14 days, accompanied by additional symptoms.
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Intracranial subdural hematoma
This symptom is associated with rupture of the “bridging veins” under the dura mater of the brain. The pain effect is focal in nature and does not depend on changes in body position. The level of consciousness decreases, vomiting and convulsions appear.
The hematoma most often forms on the left side in the area of the crown, forehead or back of the head. Rarely occupies an interhemispheric position. Surgical treatment and constant monitoring of the patient's condition are required.
Intracerebral hemorrhage
A sharp increase in pressure with existing hypotension during the spinal anesthesia procedure can cause internal hemorrhage in the brain. The pathological structure of the vessels of the cerebral hemispheres increases the risk of bleeding.
Hearing impairment
The appearance of ringing, buzzing, buzzing in the ears, decreased hearing acuity are reversible disorders that disappear without a trace after spinal anesthesia. Changes in hearing may be accompanied by dysfunction of the vestibular apparatus.
Visual impairment
The cause of the development of diplopia - double vision - is considered to be a dysfunction of the oculomotor nerves. Paralysis of these nerves causes various types of strabismus, which not only distorts the image, but also brings aesthetic discomfort to the patient.
Causes of headache after pain relief
Injections into the back area always bring pain and discomfort to the patient. The manipulations are carried out by an anesthesiologist in the operating room. Why does my head hurt after using anesthesia? Headache immediately after spinal anesthesia can occur in the following cases:
- removal of a large amount of fluid, which leads to a sharp decrease in intracranial pressure;
- exceeding the recommended amount of painkiller, which causes a sharp rise in pressure inside the skull;
- problems with the spine (osteochondrosis, previous injuries, scoliosis);
- the patient’s anxiety during the operation, which is accompanied by sudden turns of the head - this causes pressure surges;
- the use of a thick needle - cerebrospinal fluid leaks through the hole;
- congenital pathologies of the spinal cord;
- dehydration of the body.
The effects of anesthesia usually appear 1-4 hours after the anesthetics wear off. The anesthesiologist should immediately tell you about the possible side effects of anesthesia, one of which is prolonged pain in the head. If you experience cephalalgia after general anesthesia, you should consult a doctor who will determine the cause of the symptom and prescribe the necessary treatment.
Contraindications
Anesthesia with the introduction of an anesthetic into the epidural space, in addition to indications for use, also has certain contraindications. That is why you need to consult a doctor and also undergo a full examination. Contraindications may be local or absolute. The latter include the following:
- epilepsy;
- liver pathologies;
- neurotic disorders.
In addition, it is important to take into account local contraindications, which include:
- the presence of inflammatory processes in the area of pain localization;
- deviations from the development of bone structure;
- individual intolerance to the components of the anesthetic.
The procedure is not performed in case of bleeding disorders, in the case of a serious condition of the patient, or during lactation (breastfeeding).
How to relieve headaches after surgery
If you have a headache after anesthesia, treatment options can only be determined by a qualified doctor. If spinal anesthesia was used, it is recommended to spend the first postoperative hours lying down, without a pillow. You should not turn your head, try to get up, or even stand up unless your doctor gives permission.
On the first day after surgery, it is recommended to strictly follow the doctor’s instructions. It is not advisable to walk or even sit; you are only allowed to roll over, move your limbs, and carefully turn your head.
Treatment of headaches that appear as a result of anesthesia is carried out using several methods. The use of medications, the introduction of saline, an epidural patch - only the doctor decides what will most effectively cope with the complications of surgery. Each method has its own characteristics, limitations, and side reactions.
Differential diagnosis
Painful sensations are accompanied by accompanying symptoms, which an experienced anesthesiologist will pay attention to first.
The doctor diagnoses changes in the nature and intensity of PHB when the patient’s body position changes. When the inferior vena cava is compressed under the chest for one minute, a person feels relief.
Before making a diagnosis, it is necessary to measure blood pressure. It is important to exclude other causes of pain that are not related to the spinal puncture procedure.
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How to prevent headaches after pain relief
Simple measures that do not require special skills or effort will help reduce the likelihood of headaches after anesthesia. Important rules to help prevent complications:
- 10-12 hours before the administration of anesthetic solutions, refrain from drinking alcoholic beverages, food, get a good night’s sleep, and take a walk in the fresh air; the anesthetic should be administered only after the patient is in the correct position - lying on his side or sitting;
- the needle for injection must have a “pencil” sharpening - the minimum diameter of the hole will not allow cerebrospinal fluid to leak out;
- carefully follow the regimen recommended by the doctor - spend the prescribed time in bed, do not make sudden movements, and drink more fluids if possible.
Another important requirement is to sleep only in a horizontal position, on a hard surface without a pillow.
Epidural patches
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. |
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.
When using epidural therapy, special drugs are used that are injected into the epidural space. The drug begins to act after the drugs, penetrating the dura mater of the spinal cord, begin to affect the nerve endings and thereby block pain. After introducing the drug into the woman’s body, the latter loses pain and general sensitivity, and complete muscle relaxation occurs.
As with other types of pain relief, agents such as Novocaine and Lidocaine are used. If the use of additional drugs is necessary, narcotic analgesics are used, but in some countries the use of these drugs for anesthesia is prohibited.
This anesthesia is used to relieve pain in women during labor or if complications arise during childbirth. Spinal anesthesia is also used for various inflammations that occur in the area of the spinal cord roots or in the area of the intervertebral discs.
Quite rare, but nevertheless quite possible, are cases where the presented therapeutic measures are unsuccessful. In this scenario, the headache becomes more and more severe and does not stop for days. In this situation, doctors insist on using a blood patch (it is performed by an anesthesiologist).
To do this, take a small amount of blood from a vein. After this, it is introduced into the back, or more precisely, into the area in which subarachnoid anesthesia was previously performed. This leads to:
- blood naturally coagulates;
- covers the hole in the membrane (through it the flow of fluid from the spinal cord is noted).
As a result, the headache caused by the anesthesia stops. Most often, any discomfort from “applying” an epidural patch ends within one day.
Applying a patch very rarely does not bring relief. As a result, the headache that develops after subarachnoid anesthesia appears again. In this situation, repeated epidural patching stops post-puncture painful manifestations in 100% of cases.
It is important to note that the application of the described patch in certain cases is complicated by significant consequences. We can talk about infection, bleeding, sensory impairment and movement in the lower extremities. Even less likely to develop back pain. The risk of complications presented by the epidural patch is extremely small, however, it exists.
