| The review included 24 trials with 2,996 participants. Of these, 12 trials provided moderatequality evidence of increased incidence of post–dural puncture headache with bed rest compared with immediate mobilization (RR 1.24; 95% CI 1.04 to 1.48). Furthermore, 18 trials similarly provided moderatequality evidence that bed rest increased incidence of any headache compared with immediate mobilization (RR 1.16; 95% CI 1.02 to 1.32). Subgroup analyses based on indication for dural puncture, including diagnostic lumbar puncture, myelography, and spinal anesthesia, found no decreased incidence of post–dural puncture headache with bed rest. An analysis restricted to 2 trials at low risk of bias also found no decreased incidence of post–dural puncture headache with bed rest (RR 1.18; 95% CI 0.90 to 1.54).6,7 A single trial found that fluid supplementation does not decrease the incidence of post–dural puncture headache (RR 1.00; 95% CI 0.59 to 1.69). |