Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders.
Methods
A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2).
Results
The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041).
Conclusions
Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH.
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So, the question I would ask is whether much longer periods would have better stats. If about a third of patients had a headache after 1 to 4 hours of lying down, what about 6 or 8 hours?
Posted by pab (Member # 904) on :
I think a bigger issue is how much fluid is taken out. The more fluid, the longer it takes your body to adjust.
My kids had a lot of lumbar punctures. Each recovery was different.
My kids had to lay flat for 4 hours after the procedure. They usually had an IV of caffeine.
Once home, they had to lay flat for 24 hours. If they had a bad spinal headache when they got up, they had to lay flat for another 24 hours.
Drinking fluids helps. Drinking caffeine helped them more.
Posted by Lymetoo (Member # 743) on :
quote:
"The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607)."
But to those 6% it made a BIG difference to be lying down a bit longer! Posted by Keebler (Member # 12673) on :
- They just want to move people faster along the conveyer belt. But that's one belt I plan to never be on.
I wish they'd put their time into figuring out better ways to stop doing this test in the first place. There must be better ways by now - or soon, I hope.
Page two in the pdf below details that this study was conducted in Seoul, South Korea. I would suggest that people there probably take far better care of themselves than do most in the U.S. - so the results may not be the same for all populations.
Also to consider: the degree of health for each patient. I would image that those who are most well have the better outcomes.
I would hope that the needs and wishes of each patient would be considered regarding aftercare. Preventing the worst case scenario by a little extra care never hurt anyone.
19-page pdf -
Posted by Laura_W (Member # 31491) on :
I wish that the Dr who did mine would have used a 22 gauge needle!!!!!
Between the Dr using an 18 gauge needle and not being put into a laying down position after... (i tried to put myself flat, but when the nurse saw me she immediately scolded me and put me back up)
I wound up with a whopper of a spinal headache. I had a blood patch done the following day, that was a huge relief.
Just goes to show.... Never fully trust the doctors and nurses. Go with what you know!
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