Post-lumbar puncture headache: a review of issues for nursing practice

Headache is the most common complication after lumbar puncture. This narrative review explores the literature to determine strategies for preventing headache and provide evidence-based nursing care to adults with post-lumbar puncture headache. Multiple findings regarding prevention and relieving of post-lumbar puncture headache were identified and summarized under the headings ‘‘Needle Design and LP Technical Procedure,’’ ‘‘Bed Rest and Early Mobilization,’’ ‘‘Posture and Head Position,’’ ‘‘Cerebral Vasoconstriction,’’ ‘‘Hydration and Seal of the Puncture Site,’’ and ‘‘Patient Characteristics.’’ Despite the amount of articles, no widely accessible nursing practice guidelines were found. It has been shown that several treatments with insufficient or low levels of evidence supporting their efficacy are still being used (e.g., prolonged bed rest, special postures in bed, additional fluid intake, and caffeine intake). A clear recommendation regarding using atraumatic, small-sized needles. Further research is needed to support nursing with stronger evidence.