Local and regional anaesthesia: post-dural puncture headache management: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: post-dural puncture headache management

Sample item

A 28-year-old woman has a mild frontal and occipital headache on sitting up, relieved on lying flat, one day after spinal anaesthesia. She has no fever or neurological signs. What is the most appropriate initial management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hydration, simple analgesia and caffeine with reassurance

Mild post-dural puncture headache usually settles on its own and is managed conservatively with fluids, analgesics and caffeine. A blood patch is reserved for severe or persistent headache. Imaging or antibiotics are needed only if there are fever or neurological signs.

Option by option

  • A. Intravenous antibiotics

    There is no fever or meningism to suggest infection.

  • B. Hydration, simple analgesia and caffeine with reassurance (correct)

    Correct. Conservative treatment suffices for a mild positional headache.

  • C. Urgent CT head

    CT is needed only when red flags or atypical features appear.

  • D. Immediate epidural blood patch

    A blood patch is reserved for severe or persistent headache after conservative measures fail.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Hydration, simple analgesia and caffeine with reassurance. Mild post-dural puncture headache usually settles on its own and is managed conservatively with fluids, analgesics and caffeine.

Why is "Intravenous antibiotics" not the answer?

There is no fever or meningism to suggest infection.

Why is "Urgent CT head" not the answer?

CT is needed only when red flags or atypical features appear.

Why is "Immediate epidural blood patch" not the answer?

A blood patch is reserved for severe or persistent headache after conservative measures fail.

What concept does this question test?

It tests Local and regional anaesthesia: post-dural puncture headache management in Anaesthesia. A blood patch is reserved for severe or persistent headache. Imaging or antibiotics are needed only if there are fever or neurological signs.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: post-dural puncture headache management?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.