Safe and appropriate anesthesia is a priority for both patients and their surgeons. While modern anesthesia methods are considered safe and effective, all anesthesia methods carry certain risks. Spinal and epidural anesthesia can trigger a spinal headache, which can be very painful and debilitating for a post-operative patient. Your health care team may recommend caffeine as one way to treat your spinal headache.
Spinal Anesthesia
Spinal anesthesia involves placing medicine in between the bones of your spine to provide numbness and anesthesia that is adequate for surgery. The benefit of using spinal anesthesia is that you can stay awake for the procedure if you desire. You may wish to be alert and aware during a Cesarean section, for example. Spinal anesthesia can also provide post-operative pain relief.
Spinal Headache
When the spinal is placed, you may experience leakage of your cerebrospinal fluid, or CSF, into the space in your spine. When this happens, the pressure in your brain drops from its normal level and results in a headache. According to the Mayo Clinic, nearly 30 percent of patients who have spinal anesthesia will experience a spinal headache. While some patients experience a mild headache, others experience debilitating headaches that interfere with their ability to recover after surgery.
Treatment with Caffeine
Caffeine is a stimulant which may help reduce the pain of a spinal headache by causing the blood vessels in the brain to constrict, which could increase the CSF pressure in the brain. Your anesthesiologist may elect to give you caffeine through your IV. While the use of oral caffeine may reduce the pain of spinal headaches temporarily, patients often note that the pain returns later.
Other Treatment
While caffeine is one part of treating a spinal anesthesia headache, your doctor may recommend other treatment methods. Your doctor may advise that you use oral hydration, analgesics and bed rest as a first line method of treatment. If your headache persists for more than 24 hours, you may be a candidate for an epidural blood patch, or EBP. For an EBP, your anesthesiologist injects some of your blood into your spinal space. When the blood clots, it patches the hole and prevents further leakage of CSF.
References
- Cleveland Clinic: Spinal Headache
- MayoClinic.com; Spinal Headaches; February 20, 2010
- University of Illinois at Chicago College of Pharmacy: Is Caffeine Effective for the Treatment of Postdural Puncture Headache
- Society for Obstetric Anesthesia and Perinatology; Pathophysiology and Management of Post-dural Puncture Headache - A Current Review; S. Schwalbe



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