One among the following is the complication of spinal anesthesia :

IGNOU PB Bsc Entrance-2023

Medical Surgical Nursing

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Appeared in: IGNOU PB Bsc Entrance-2023

Explanation

Headache, specifically a Post-Dural Puncture Headache (PDPH), is a classic and common complication following spinal anesthesia.
It is caused by the leakage of cerebrospinal fluid (CSF) from the puncture site in the dura mater.
This loss of CSF volume and pressure causes downward traction on pain-sensitive structures within the skull, leading to a headache that typically worsens when sitting or standing and improves when lying down.

Option A: Hiccoughs are not a recognized or common complication directly related to the procedure or medications used in spinal anesthesia.
Option B: Numbness of the legs is an expected and intended therapeutic effect of spinal anesthesia, resulting from the blockade of sensory nerve roots. It is a sign that the anesthesia is working, not a complication.
Option D: While urinary retention (bladder dysfunction) is a known potential complication due to the anesthetic's effect on the autonomic nerves controlling the bladder, PDPH is the most specific and hallmark complication directly resulting from the dural puncture procedure itself.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Spinal Anesthesia as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to assess patients post-spinal anesthesia for headache, specifically noting its postural nature (worse when upright, better when supine), which is pathognomonic for PDPH.
Nursing interventions are crucial for management and include enforcing bed rest in a supine position, promoting hydration, administering prescribed analgesics, and providing patient education.
What if? If a post-spinal headache is severe, persistent despite conservative measures, and accompanied by neurological symptoms like vision changes or neck stiffness, it could indicate a more serious complication like a subdural hematoma or meningitis, requiring urgent medical evaluation.

How to Approach the Question

First, identify the core of the question, which asks for a complication of spinal anesthesia.
Next, evaluate each option to determine if it is a complication, an expected effect, or unrelated.
Recognize that 'Numbness of legs' is a desired therapeutic effect of the anesthetic block, not an adverse event. Therefore, eliminate this option.
Consider 'Hiccoughs'. This is not a commonly cited complication of spinal anesthesia, making it an unlikely answer.
Compare the remaining options: 'Headache' and 'No urge to void' (urinary retention). Both are recognized complications.
Differentiate between the two. Post-dural puncture headache is a direct result of the physical procedure of puncturing the dura. Urinary retention is an effect of the anesthetic drug on the nerves. In medical and nursing exams, the most direct and classic complication, PDPH, is often the intended correct answer.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 64-86