Postdural puncture headache: prevention

Postdural puncture headache, a complication of puncture of the spinal dura mater, is a common side-effect of spinal anesthesia and lumbar puncture. Its incidence can be reduced with the thinnest possible needles use, with pencil-point tips instead of Quincke-point tips, lateral orientation of Quincke-point bevel, and with stylet reinsertion after puncture. Drugs and hydration are less effective. Bed-rest is ineffective.