Side Effects of Lumbar Anesthesia: What to Expect and Do

Q: Side Effects of Lumbar Anesthesia: What to Expect and Do

Hello： 1. <br>Prolonged lying down should not cause any issues. <br>2. <br>Increasing water intake should help, and a brain CT scan is likely unnecessary.

Side effects caused by lumbar anesthesia (spinal anesthesia)?

Hello, doctor.
The current symptoms seem to be side effects caused by lumbar anesthesia (spinal anesthesia).
(I researched online and found related cases for my judgment.) My family member went into the operating room at noon on February 15 for a laser endoscopic procedure to break up kidney stones and had a double J stent placed.
They returned to the ward to rest by 2 PM and were discharged the next day, February 16, at 10 AM.
During this time, they consistently felt some pain in the forehead.
On the way home from the hospital, they began to experience headaches and nausea.
These headache symptoms seemed to improve when lying down and were less painful.
Two days later (February 18), the headache became unbearable, and they were urgently taken to the emergency room, where the doctor only prescribed pain medication.
They are currently resting at home.
I would like to ask the doctor: 1.
Is my judgment correct? 2.
If my judgment is correct, how should we resolve this now? If we go to the hospital, will the doctors need to perform a CT scan of the brain or a lumbar puncture to diagnose the cause? We returned home from the emergency room because we were concerned that a second lumbar puncture might cause further brain injury.
My family member has been resting at home for a day after leaving the emergency room, but upon getting up, they still feel the headache gradually worsening.
What should we do?

Niming, 20~29 year old female. Ask Date: 2011/02/19

Dr. Ye Boshou reply Neurology

Hello: 1.
Prolonged lying down should not cause any issues.
2.
Increasing water intake should help, and a brain CT scan is likely unnecessary.

Reply Date: 2011/02/19

More Info

Lumbar anesthesia, commonly referred to as spinal anesthesia or half-body anesthesia, is a technique used to provide pain relief during surgical procedures, particularly those involving the lower body. While it is generally considered safe and effective, it can lead to certain side effects and complications, some of which you seem to be experiencing.

Understanding Your Symptoms
Based on your description, it appears that you are experiencing a post-dural puncture headache (PDPH), which is a known complication of spinal anesthesia. This type of headache typically occurs when there is a leak of cerebrospinal fluid (CSF) from the puncture site, leading to decreased pressure in the spinal canal. Symptoms of PDPH can include:
- Severe headache that worsens when sitting or standing and improves when lying down.

- Nausea and vomiting.

- Neck stiffness.

- Visual disturbances.

Your experience of feeling better when lying down is characteristic of PDPH. The timing of your symptoms, starting with mild discomfort and escalating to severe pain, aligns with this condition.

What to Expect and Do
1. Diagnosis: If you suspect that your symptoms are due to PDPH, it is crucial to consult a healthcare professional. While a CT scan or MRI can help rule out other potential causes of headache, such as bleeding or other complications, PDPH is primarily diagnosed based on your symptoms and medical history.

2. Management: The management of PDPH typically includes:
- Conservative Treatment: This may involve bed rest, hydration, and the use of over-the-counter pain relievers like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). Caffeine can also be beneficial, as it may help constrict blood vessels and alleviate headache symptoms.

- Epidural Blood Patch: If conservative measures fail, an epidural blood patch may be performed. This involves injecting a small amount of your own blood into the epidural space to seal the leak and restore normal CSF pressure.

3. When to Seek Immediate Care: If your headache worsens significantly, or if you experience additional symptoms such as confusion, severe neck stiffness, or neurological deficits (like weakness or numbness), you should seek immediate medical attention. These could indicate more serious complications that require prompt evaluation.

Concerns About Further Procedures
Your apprehension about undergoing another spinal tap (lumbar puncture) is understandable, especially if you are already experiencing significant discomfort. However, if your healthcare provider deems it necessary to rule out other conditions, they will take precautions to minimize risks. It is essential to communicate your concerns with your doctor, who can explain the rationale for any further procedures and discuss the risks versus benefits.

Conclusion
In summary, it is plausible that your symptoms are related to post-dural puncture headache following lumbar anesthesia. While this condition can be distressing, it is often manageable with conservative treatment or an epidural blood patch if necessary. Always keep an open line of communication with your healthcare provider regarding your symptoms and any concerns you may have. Your well-being is paramount, and they can provide the best guidance tailored to your specific situation.

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