Cefaleia pós-raquianestesia: etiologia e estratégias de manejo.

Abstract

Spinal anesthesia is widely used in clinical practice; however, it may be associated with Postdural puncture headache (PDPH), its most common complication, resulting from cerebrospinal fluid leakage following dural puncture. This study aimed to review the literature regarding the pathophysiology, risk factors, clinical manifestations, management, and preventive strategies of PDPH. Academic articles and studies published between 2017 and 2025 were analyzed, including papers indexed in scientific journals and databases such as Google Scholar, BVS, SciELO, and the UpToDate platform. Both nonmodifiable factors, such as age and sex, and modifiable factors related to technique, needle type and gauge, and practitioner experience were addressed. The findings indicate that the use of atraumatic needles, proper bevel orientation, and a reduced number of puncture attempts are associated with a lower incidence of this complication. Management is conservative in most cases, with the epidural blood patch reserved for severe or refractory presentations. It is concluded that prevention, combined with individualized patient assessment, is essential to reduce morbidity associated with PDPH and to enhance the safety of patients undergoing spinal anesthesia.