Keywords
Postoperative headache
Spinal anesthesia
Analgesia
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Abstract
Objective: To analyze the multimodal management and outcomes of postoperative headache in surgeries performed under spinal anesthesia through a narrative review of the literature. Literature review: Postoperative headache associated with spinal anesthesia represents a frequent and relevant complication, with a direct impact on quality of life, functional recovery, and length of hospital stay. Its pathophysiology is mainly related to cerebrospinal fluid loss, leading to intracranial hypotension and compensatory cerebral vasodilation, in addition to the involvement of inflammatory mechanisms. Technical factors, such as the type and gauge of the needle used, the number of puncture attempts, and the professional’s experience, as well as individual patient factors, significantly influence its incidence. Preventive strategies include proper anesthetic technique, the use of atraumatic needles, and preventive analgesia. Multimodal management, involving non-opioid analgesics, adjuvant therapies, and, when indicated, epidural blood patch, has demonstrated effectiveness in reducing pain, opioid consumption, and improving clinical outcomes. Final considerations: This approach promotes greater perioperative safety, faster functional recovery, and better clinical outcomes, highlighting the need for further studies to standardize therapeutic approaches.
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