Post-dural lumbarpuncture headache (PDPH) occurs in 10-30% of patients following spinal anesthesia. There is limited data on the influence of post-operative patient positioning onresolution of PDPH. We aimed to study the influence of prone positioning on rate of resolution of PDPH.

We did a retrospective, cohort study of patients who developed PDPH between January-December 2013. Patients who had infra-umbilical surgeries and no contra-indications for lying prone were included, andpositioned prone once they developed PDPH. Patients who refused to lie prone served as controls. All patients received analgesics. The intensity of pain was recorded using VAS. Chi-square test and students t test were used for statistical analysis.

Of the 78 patients with PDPH, 48 patients were positioned prone. Mean age was 45.68 ± 16.79 years, with 65.38% males. There was no significant difference in age, gender and BMI between the two groups. Baseline pain score was significantly higher in patients positioned prone (4.31 Vs 3.67, p = 0.001). The time to resolution of PDPH was significantly lower in patients positioned prone (8.54 Vs 9.60 hours, p = 0.030).

Patients positioned prone following PDPH had significantly faster resolution of headache, despite having a higher baseline pain score. Prone position raises intra‐abdominal pressure, which is transmitted to the epidural space thereby alleviating the headache. However, a previous clinical trial failed to demonstrate significant benefit.

Prone positioning of patients after development of PDPH significantly shortens the duration of headache. This intervention needs to be tested ina prospective randomized trial.