[Headache following spinal anesthesia: also a problem of the local anesthetic used?]

In a prospective clinical study we followed 320 patients operated upon in spinal anesthesia. We were especially interested in headache patterns after spinal anesthesia and their causes, with particular reference to the local anesthetic used. Apart from the typical postspinal headache due to low cerebrospinal fluid (CSF) pressure, we found a nontypical pattern which was considerably more prevelant than the classical type. The typical postspinal headache correlated well with procedures (multiple perforations, thicker cannulae) that lower or prolong the reduction of CSF pressure and a history of migraine. The nontypical headache correlated with the use of lignocaine/articaine for spinal anesthesia, possibly due to metabolic and structural factors.