Effect of Posture on Post Lumbar Puncture Headache after Spinal Anesthesia: A Prospective Randomized Study

Background Headache after lumbar puncture has long been attributed to early mobilization, and hence prophylactic bed rest had been standard protocol to prevent spinal headache after lumbar puncture. However, trend has been changing towards early mobilization to no need of bed rest at all after lumbar puncture. Objective To study the influence of posture in the incidence of post lumbar puncture headache in patients undergoing spinal anesthesia. Method In a prospective randomized study, patients undergoing various surgical procedures under spinal anesthesia from February 2013 to January 2014 were included. They were randomly allocated into two groups; group A, no restriction of position and group B, 24 hours bed rest after spinal anesthesia. Two groups were compared with regards to spinal anesthesia complications such as headache, backache, urinary retention, nausea and vomiting. Result Total of 112 patients, 58 in group A and 54 in group B, were enrolled in the study. The mean age was 40.13±17.4 years and male: female ratio was 2.5:1. Post spinal headache was observed in 13(22.4%) patients in group A and 13 (24.0%) patients in group B which was statistically not significant (p=0.755). Similarly, there was no significant difference of headache score, and the incidence of other complications like backache, nausea, vomiting and urinary retention between two groups. Conclusion There is no significant influence in the incidence of post lumbar puncture headache by early mobilization after spinal anesthesia. Hence, prophylactic bed rest following spinal anesthesia is of no benefit.