How can you prevent a spinal headache after spinal anesthesia?

• A. Keep client supine
• B. Encourage early ambulation
• C. Increase fluids
• D. Administer caffeine

Answer: (A)

Post-dural puncture headache after spinal anesthesia happens when cerebrospinal fluid leaks through the puncture site, causing relief by keeping the brain and meninges pulled downward. The most effective way to prevent this headache is to keep the patient flat (supine) for several hours after the procedure. The horizontal position minimizes pressure changes and supports the puncture site as it seals, reducing ongoing CSF loss and the risk of headache.

Encouraging early ambulation can increase CSF leakage and the likelihood of a post-dural puncture headache, so it’s not a preventive approach. Fluids and caffeine are often discussed for managing PDPH after it occurs—caffeine can help with symptoms due to vasoconstriction and fluid shifts—but they are not reliable primary preventive measures before a headache develops.