Abstract
BACKGROUND: Lumbar puncture (LP) is a common diagnostic procedure in the emergency department (ED). Post-dural puncture headache (PDPH) is the most frequent complication following LP. Despite evidence suggesting that strict bed rest does not prevent PDPH, patients in Taiwan are often required to remain in a supine position for 6 to 8 hours post-LP, leading to prolonged ED stays. This study aims to evaluate the impact of strict bed rest on the incidence of PDPH and ED length of stay (LOS). METHODS: A retrospective cohort study was conducted at a medical center in central Taiwan, involving all adult ED patients who underwent LP from September 1, 2023, to March 31, 2024. Emergency specialists determined the need for strict bed rest based on individual patient conditions. Nurse practitioners recorded the occurrence of PDPH and ED LOS. Patients with incomplete data were excluded. RESULTS: Out of 76,691 adult ED patients, 143 patients underwent LP, with 141 patients included in the final analysis. Among 68 assessable patients, 52 patients did not rest supine and 16 patients did, showing no significant difference in PDPH occurrence (p = 0.634). Overall, 55 patients did not rest supine, and 86 patients did, with significant differences in ED LOS: 9 hours for non-supine rest versus 19 hours for supine rest (p < 0.001). CONCLUSION: Reducing routine post-LP bed rest does not increase the risk of PDPH and might reduce LOS in the ED.