No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle

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).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).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.Lumbar puncture (LP) is an essential medical procedure in many clinical practices. Although LP is relatively safe, several adverse events have been reported, including headache, hemorrhage, local pain, and infections[1]. Among these adverse events, post-lumbar puncture headache (PLPH) is the most frequent and disabling in many patients. The International Headache Society has defined a PLPH as a headache that develops within 5 days of dural puncture and resolves within 1 week spontaneously or within 48 hours after effective treatment of the spinal fluid leak (usually by epidural blood patch)[2]. The headache usually worsens within 15 minutes after sitting or standing, and disappears or improves within 15 minutes after lying down. The headache is generally located in the frontal or occipital areas, or both, but may also involve the neck and upper shoulders. The severe PLPH may be associated with nausea, vomiting, blurred vision, vertigo, hearing alteration, and back pain[3].PLPH has been considere