There is no expectation that you will have looked at any of these before the session, but if you have time to do so then you might find it useful, again starting with the areas you are least confident on

•Onset is typically within 2–3 days of the dural puncture, but can occasionally be much sooner or later

•Symptoms are classically a searing frontal or occipital headache, sometimes exacerbated by head movement / upright posture, and relieved by lying down

•Symptoms can, however, be confusingly nebulous eg neck stiffness, nausea, vomiting, hearing loss, tinnitus, vertigo, paraesthesia and visual disturbance. 

Therapy:
•Get an expert in, someone who sees them often, normally an obs anaes:

•maximum analgesia, typically paracetamol, an NSAID and a weak opioid.

•Failure of this regimen should prompt consideration of an epidural blood patch.

•GA is associated with as high or higher rate of neurological symptoms

•neurological symptoms that arise even 2 weeks after a single-shot block should not be dismissed lightly

•Some neurological symptoms after PNB are common (0-2.2% up to 3/12; 0-0.2% up to 12/12)

•Rarely permanent (1:20k-1:5k ie 0.005-0.02%)
If occurs:

•Document Document Document ..

•Urgent imaging (MRI) and neurological referral to exclude treatable leisons (haematoma, abscess)

•Consider Urgent surgery

•Urgent and/or delayed electrophysiological studies (?pre-existing deficit)

•Vaso-vagal reactions, profound bradycardia, even asystole: beware spinals in the sitting, awake, anxious, dehydrated young fit male
•Hemi diaphragmatic paresis: occurs in Interscalene BP blocks (100%); Supraclavicular (50%)

•Pneumothorax: eg Brachial plexus*; paravertebral

•Failure / not meeting patient expectations

•Bladder dysfunction: spinals for hip/knees convey 5% catherisation rate

•Delayed diagnosis of compartment syndrome: recent AA standards on prevention and treatment

•Falls / failed mobilisation due to unintentionally long lasting blocks

•Awake might be easier to defend

•Shared decision making recommended

•If done awake, record response and initial function*

Useful summary at 14 mins onwards