Volume 22, Issue 5 (Iranian South Medical Journal 2019)                   Iran South Med J 2019, 22(5): 307-316 | Back to browse issues page


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Najafi Anaraki A, Mirzaei K. Comparing the Prophylactic Effect of Pregabalin with that of Aminophylline Plus Dexamethasone on Postdural Puncture Headache after Spinal Anesthesia in Cesarean Section: A Double-Blind Controlled Randomized Clinical Trial. Iran South Med J 2019; 22 (5) :307-316
URL: http://ismj.bpums.ac.ir/article-1-1174-en.html
1- Department of Anesthesiology, School of Medical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran
2- Department of Community Medicine, School of Medical Sciences, Bushehr University of Medical Sciences, Bu-shehr, Iran , Kamran.mirzaei@gmail.com
Abstract:   (3448 Views)
Background: Headache is yet considered an undesirable complication of spinal anesthesia as a selective method in cesarean section. The present study was conducted to compare the prophylactic effect of pregabalin with that of aminophylline plus dexamethasone on postdural puncture headache after spinal anesthesia in cesarean section.
Materials and Methods: The present double-blind controlled randomized clinical trial assigned 375 pregnant women as volunteers for elective cesarean section to three groups of 125 receiving pregabalin, aminophylline plus dexamethasone and placebo. Observational evaluation of the incidence and severity of headache was performed in these patients within the first 24 postoperative hours, i.e. 6, 12 and 24 hours after the surgery.
Results: No statistically-significant differences were observed between the three groups receiving pregabalin, aminophylline plus dexamethasone and placebo in terms of the incidence and severity of headache 6, 12 and 24 hours after cesarean section performed under spinal anesthesia.
Conclusion: The prophylactic administration of pregabalin or aminophylline plus dexamethasone does not affect postdural puncture headache after spinal anesthesia in cesarean section.
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Type of Study: Original | Subject: Gynecology
Received: 2019/05/18 | Accepted: 2019/08/21 | Published: 2019/12/1

References
1. Ona XB, Tuma SM, García LM, et al. Drug Therapy for Preventing Post‐Dural Puncture Headache. Cochrane Database Syst Rev 2013; (2): 1-74.
2. Arevalo‐Rodriguez I, Ciapponi A, i Figuls MR, et al. Posture and Fluids for Preventing Post‐Dural Puncture Headache. Cochrane Database Syst Rev 2016; (3): 1-66. [DOI:10.1002/14651858.CD009199.pub3]
3. Flaatten H, Rodt S, Rosland J, et al. Postoperative Headache in Young Patients After Spinal Anaesthesia. Anaesthesia 1987; 42(2): 202-5. [DOI:10.1111/j.1365-2044.1987.tb03001.x]
4. Cohen S, Amar D, Pantuck EJ, et al. Decreased Incidence of Headache After Accidental Dural Puncture in Caesarean Delivery Patients Receiving Continuous Postoperative Intrathecal Analgesia. Acta Anaesthesiol Scand 1994; 38(7): 716-8. [DOI:10.1111/j.1399-6576.1994.tb03983.x]
5. Evans RW, Armon C, Frohman EM, et al. Assessment: Prevention of Post-Lumbar Puncture Headaches: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2000; 55(7): 909-14. [DOI:10.1212/WNL.55.7.909]
6. Safa-Tisseront V, Thormann F, Malassiné P, et al. Effectiveness of Epidural Blood Patch in the Management of Post-Dural Puncture Headache. Anesthesiology 2001; 95(2): 334-9. [DOI:10.1097/00000542-200108000-00012]
7. Ahmed SV, Jayawarna C, Jude E. Post Lumbar Puncture Headache: Diagnosis and Management. Postgrad Med J 2006; 82(973): 713-6. [DOI:10.1136/pgmj.2006.044792]
8. Kuczkowski KM. Post-Dural Puncture Headache in the Obstetric Patient: an Old Problem. New Solutions. Minerva Anestesiol 2004; 70(12): 823-30.
9. Naghibi K, Hamidi M. Prophylactic Administration of Aminophylline Plus Dexamethasone Reduces Post-Dural Puncture Headache Better than Using Either Drug Alone in Patients Undergoing Lower Extremity Surgery. Adv Biomed Res 2014; 3: 5. [DOI:10.4103/2277-9175.124631]
10. Sadeghi SE, Abdollahifard G, Nasabi NA, et al. Effectiveness of Single Dose Intravenous Aminophylline Administration on Prevention of Post Dural Puncture Headache in Patients Who Received Spinal Anesthesia for Elective Cesarean Section. World J Med Sci 2012; 7(1): 13-6.
11. Yousefshahi F, Dahmardeh AR, Khajavi M, et al. Effect of Dexamethasone on the Frequency of Postdural Puncture Headache After Spinal Anesthesia for Cesarean Section: A DoubleBlind Randomized Clinical Trial. Acta Neurol Belg 2012; 112(4): 345-50. [DOI:10.1007/s13760-012-0065-6]
12. Yang B, Li DL, Dong P, et al. Effect of Dexamethasone on the Incidence of Post-Dural Puncture Headache After Spinal Asthesia: A Randomized, Double-Blind, PlaceboControlled Trial and a Meta-Analysis. Acta Neurol Belg 2015; 115(1): 59-67. [DOI:10.1007/s13760-014-0307-x]
13. Mahoori A, Noroozinia H, Hasani E, et al. Comparing the Effect of Pregabalin, Gabapentin, and Acetaminophen on Post-Dural Puncture Headache. Saudi J Anaesth 2014; 8(3): 374-7. [DOI:10.4103/1658-354X.136436]
14. Clark JW, Solomon GD, Senanayake PD, et al. Substance P Concentration and History of Headache in Relation to Postlumbar Puncture Headache: Towards Prevention. J Neurol Neurosurg Psychiatry 1996; 60(6): 681-3. [DOI:10.1136/jnnp.60.6.681]
15. Zencirci B. Postdural Puncture Headache and Pregabalin. J Pain Res 2010; 3: 11-4. [DOI:10.2147/JPR.S9445]
16. Sprigge JS, Harper SJ. Accidental Dural Puncture and Post Dural Puncture Headache in Obstetric Anaesthesia: Presentation and Management: A 23‐Year Survey in a District Ggeneral Hospital. Anaesthesia 2008; 63(1): 36-43. [DOI:10.1111/j.1365-2044.2007.05285.x]
17. Yadav A, Chatterjee AS, Gehdoo RP. Pregabalin for Refractory Postdural Puncture Headache. J Anaesthesiol Clin Pharmacol 2015; 31(2): 258-260. [DOI:10.4103/0970-9185.155163]
18. Turnbull DK, Shepherd DB. Post‐Dural Puncture Headache: Pathogenesis, Prevention and Treatment. Br J Anaesth 2003; 91(5): 718-29. [DOI:10.1093/bja/aeg231]
19. Dahlgren G, Hultstrand C, Jakobsson J, et al. Intrathecal Sufentanil, Fentanyl, or Placebo Added to Bupivacaine for Cesarean Section. Anesth Analg 1997; 85(6): 1288-93. [DOI:10.1213/00000539-199712000-00020]
20. Ahluwalia P, Jain P. Effect of Gabapentin Premedication on Post Dural Puncture Headache in Patients Undergoing Elective Cesarean Section. Acad Anesthesiol Int 2017; 2(1): 35-8. [DOI:10.21276/aan.2017.2.1.9]
21. El Rahmawy G, Rashwan D, Mohamed NN. The Efficacy of Preoperative Pregabalin on Reduction of the Incidence and Severity of Postdural Puncture Headache After Spinal Anesthesia. Egypt J Anaesth 2013; 29(4): 357-61. [DOI:10.1016/j.egja.2013.04.001]
22. Hamzei A, Basiri-Moghadam M, PasbanNoghabi S. Effect of Dexamethasone on Incidence of Headache After Spinal Anesthesia in Cesarean Section. A Single Blind Randomized Controlled Trial. Saudi Med J 2012; 33(9): 948-53.
23. Ona XB, Tuma SM, García LM, et al. Drug Therapy for Preventing Post‐Dural Puncture Headache. Cochrane Database Syst Rev 2013; (2): 1-74.
24. Arevalo‐Rodriguez I, Ciapponi A, i Figuls MR, et al. Posture and Fluids for Preventing Post‐Dural Puncture Headache. Cochrane Database Syst Rev 2016; (3): 1-66. [DOI:10.1002/14651858.CD009199.pub3]
25. Flaatten H, Rodt S, Rosland J, et al. Postoperative Headache in Young Patients After Spinal Anaesthesia. Anaesthesia 1987; 42(2): 202-5. [DOI:10.1111/j.1365-2044.1987.tb03001.x]
26. Cohen S, Amar D, Pantuck EJ, et al. Decreased Incidence of Headache After Accidental Dural Puncture in Caesarean Delivery Patients Receiving Continuous Postoperative Intrathecal Analgesia. Acta Anaesthesiol Scand 1994; 38(7): 716-8. [DOI:10.1111/j.1399-6576.1994.tb03983.x]
27. Evans RW, Armon C, Frohman EM, et al. Assessment: Prevention of Post-Lumbar Puncture Headaches: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2000; 55(7): 909-14. [DOI:10.1212/WNL.55.7.909]
28. Safa-Tisseront V, Thormann F, Malassiné P, et al. Effectiveness of Epidural Blood Patch in the Management of Post-Dural Puncture Headache. Anesthesiology 2001; 95(2): 334-9. [DOI:10.1097/00000542-200108000-00012]
29. Ahmed SV, Jayawarna C, Jude E. Post Lumbar Puncture Headache: Diagnosis and Management. Postgrad Med J 2006; 82(973): 713-6. [DOI:10.1136/pgmj.2006.044792]
30. Kuczkowski KM. Post-Dural Puncture Headache in the Obstetric Patient: an Old Problem. New Solutions. Minerva Anestesiol 2004; 70(12): 823-30.
31. Naghibi K, Hamidi M. Prophylactic Administration of Aminophylline Plus Dexamethasone Reduces Post-Dural Puncture Headache Better than Using Either Drug Alone in Patients Undergoing Lower Extremity Surgery. Adv Biomed Res 2014; 3: 5. [DOI:10.4103/2277-9175.124631]
32. Sadeghi SE, Abdollahifard G, Nasabi NA, et al. Effectiveness of Single Dose Intravenous Aminophylline Administration on Prevention of Post Dural Puncture Headache in Patients Who Received Spinal Anesthesia for Elective Cesarean Section. World J Med Sci 2012; 7(1): 13-6.
33. Yousefshahi F, Dahmardeh AR, Khajavi M, et al. Effect of Dexamethasone on the Frequency of Postdural Puncture Headache After Spinal Anesthesia for Cesarean Section: A DoubleBlind Randomized Clinical Trial. Acta Neurol Belg 2012; 112(4): 345-50. [DOI:10.1007/s13760-012-0065-6]
34. Yang B, Li DL, Dong P, et al. Effect of Dexamethasone on the Incidence of Post-Dural Puncture Headache After Spinal Asthesia: A Randomized, Double-Blind, PlaceboControlled Trial and a Meta-Analysis. Acta Neurol Belg 2015; 115(1): 59-67. [DOI:10.1007/s13760-014-0307-x]
35. Mahoori A, Noroozinia H, Hasani E, et al. Comparing the Effect of Pregabalin, Gabapentin, and Acetaminophen on Post-Dural Puncture Headache. Saudi J Anaesth 2014; 8(3): 374-7. [DOI:10.4103/1658-354X.136436]
36. Clark JW, Solomon GD, Senanayake PD, et al. Substance P Concentration and History of Headache in Relation to Postlumbar Puncture Headache: Towards Prevention. J Neurol Neurosurg Psychiatry 1996; 60(6): 681-3. [DOI:10.1136/jnnp.60.6.681]
37. Zencirci B. Postdural Puncture Headache and Pregabalin. J Pain Res 2010; 3: 11-4. [DOI:10.2147/JPR.S9445]
38. Sprigge JS, Harper SJ. Accidental Dural Puncture and Post Dural Puncture Headache in Obstetric Anaesthesia: Presentation and Management: A 23‐Year Survey in a District Ggeneral Hospital. Anaesthesia 2008; 63(1): 36-43. [DOI:10.1111/j.1365-2044.2007.05285.x]
39. Yadav A, Chatterjee AS, Gehdoo RP. Pregabalin for Refractory Postdural Puncture Headache. J Anaesthesiol Clin Pharmacol 2015; 31(2): 258-260. [DOI:10.4103/0970-9185.155163]
40. Turnbull DK, Shepherd DB. Post‐Dural Puncture Headache: Pathogenesis, Prevention and Treatment. Br J Anaesth 2003; 91(5): 718-29. [DOI:10.1093/bja/aeg231]
41. Dahlgren G, Hultstrand C, Jakobsson J, et al. Intrathecal Sufentanil, Fentanyl, or Placebo Added to Bupivacaine for Cesarean Section. Anesth Analg 1997; 85(6): 1288-93. [DOI:10.1213/00000539-199712000-00020]
42. Ahluwalia P, Jain P. Effect of Gabapentin Premedication on Post Dural Puncture Headache in Patients Undergoing Elective Cesarean Section. Acad Anesthesiol Int 2017; 2(1): 35-8. [DOI:10.21276/aan.2017.2.1.9]
43. El Rahmawy G, Rashwan D, Mohamed NN. The Efficacy of Preoperative Pregabalin on Reduction of the Incidence and Severity of Postdural Puncture Headache After Spinal Anesthesia. Egypt J Anaesth 2013; 29(4): 357-61. [DOI:10.1016/j.egja.2013.04.001]
44. Hamzei A, Basiri-Moghadam M, PasbanNoghabi S. Effect of Dexamethasone on Incidence of Headache After Spinal Anesthesia in Cesarean Section. A Single Blind Randomized Controlled Trial. Saudi Med J 2012; 33(9): 948-53.

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