Postpartum lady after 48 hours of cesarean section, suffering from headache and signs of meningism. Headache gets relieved on lying down. Immediate treatment would be:
Ans. A. Epidural blood patchExplanationAs patient has signs of meningism, the treatment would be epidural blood patch.The Lybecker classification of severity for PDPH:Mild PDPH (Score 1)Postural headache with slight restriction of daily activities.Not bedridden.No associated symptoms.Responds well to non-opiate analgesics (Paracetamol, NSAID, Caffeine).Moderate PDPH (Score 2)Postural headache with significant restriction of daily activities.Bedridden part of the day associated symptoms may or may not present.Requires the addition of opiate derivatives.Severe PDPH (Score 3)Postural headache with complete restriction of daily activities.Bedridden all day associated symptoms present (photophobia, diplopia, tinnitus, nausea, vomiting).Not responsive to the above conservative management.If the question was like this:
Epidural blood patch
Do lumbar puncture
Foot end elevation
Sumatriptan
Complications Of Anaesthesia