Cefalea post punción según el abordaje anestésico. Revisión Sistemática

Abstract

Lumbar puncture is a widely used technique, both inside and outside the operating room, for diagnostic, therapeutic, and anesthetic purposes. A common complication following this procedure is post-dural puncture headache (PDPH), which is typically characterized by a frontal or bilateral headache and is often accompanied by additional symptoms such as visual and auditory disturbances. Methods: A descriptive, cross-sectional, and retrospective systematic review was conducted using a non-experimental design. The review considered articles identifying the characteristics of post-dural puncture headache, published between 2019 and 2023, in English and Spanish. The databases consulted included PubMed, Taylor & Francis, Dialnet, Elsevier, Medline, and Scopus. Systematic reviews and articles that did not fall within the five-year publication window or were not written in English or Spanish were excluded. Results: This study demonstrated that age, sex, body mass index (BMI), puncture approach, needle type and gauge, and operator experience are significant risk factors. It is clear that the most effective treatment is the epidural blood patch, with its indications, as it significantly alleviates symptoms compared to conservative treatment methods. The fibrin patch is also considered as a viable alternative. Conclusions: Despite all the studies that have been carried out on CPPD, the frequency of this complication after a lumbar puncture is still reported; this study made it possible to identify the factors that influence the appearance of this condition, the most appropriate treatment and thus reduce its incidence. Keywords: headache, spinal puncture, spinal anesthesia