Arevalo-Rodriguez I, Ciapponi A, Roqué I, et al. (2016). Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev 3:CD009199
Post-dural puncture headache (PDPH) complicates up to 30% of lumbar punctures (LP). Bed rest and supplementary fluids administration are common preventative practices after a LP.
Does bed rest and/or additional fluids administration decrease the risk of PDPH following LP?
Bed rest (4 to 24h) increases the incidence of PDPH and any headache after LP compared to immediate mobilization (moderate level of evidence). Various head postures or prone body position have no beneficial effect. Supplementary fluids administration has no benefit on the development of PDPH (low level of evidence).
A sub-analysis including only studies with the lowest risk of bias confirmed the lack of benefit of bed rest following LP. Because of the various types of hydration methods used (oral, intra-venous, volume of hydration) and the small number of included studies, this meta-analysis cannot make definitive conclusions with respect to the administration of supplementary fluids for the prevention of PDPH.
Hospices civils de Lyon, CHU Lyon-Sud,
Centre Hospitalier Régional Universitaire de Brest
Dalhousie University –QEII Health Science Centre
Nova Scotia, Canada