Effect of dexamethasone on the incidence of post-dural puncture headache after spinal anesthesia: a randomized, double-blind, placebo-controlled trial and a meta-analysis

2014 ◽  
Vol 115 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Bo Yang ◽  
Dong-Liang Li ◽  
Ping Dong ◽  
Xi-Yan Zhang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Double Blind ◽  
Post Dural Puncture Headache ◽  
Double Blind Placebo

scholarly journals Effects of Dexamethasone on Post-dural Puncture Headache in Patients Undergoing Orthopedic Surgery

2020 ◽  
Vol 13 (1) ◽  
pp. 42-46
Author(s):  
Hadis Barkhori ◽  
Farhad Arefi ◽  
Kiavash Hushmandi ◽  
Salman Daneshi ◽  
Jafar Salehi ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Dural Puncture ◽  
Controlled Trial ◽  
Study Groups ◽  
Control Group ◽  
Double Blind ◽  
Post Dural Puncture Headache ◽  
Double Blind Placebo ◽  
Dexamethasone Group ◽  
Post Operative Period

Background: The effect of Dexamethasone on Post-Dural Puncture Headache (PDPH) after spinal anesthesia has not been well elucidated. The aim of the current study was to evaluate the effect of prophylactic intravenous dexamethasone on the incidence and severity of PDPH in patients undergoing orthopedic surgery. Methods: This randomized, double-blind, placebo-controlled trial was carried out in patients undergoing orthopedic surgery. The subjects were randomly divided into a placebo (n=140) and a dexamethasone (n=140) group. During the surgery, the control group participants were injected 2cc of distilled water, and the dexamethasone group participants were injected 2cc (8mg) of dexamethasone as an infusion in the veins. The incidences of PDPH on the first, third and seventh postoperative days were studied. Data were analyzed using SPSS version 22. Results: A total of 280 patients with a mean age of 32.7 ± 11.0 years were studied. The incidence of PDPH on the first day of post-operative period was lower in the dexamethasone group than the control group (21 vs. 34, P<0.05). This difference was disappeared on days 3 and 7. Nausea or vomiting occurred less in the dexamethasone group (9 vs. 26, P<0.05). However, no statistically significant association was found between study groups and the incidence of back pain (P>0.05). Conclusion: Although the frequency of PDPH was less in patients receiving dexamethasone, the incidence increased days after the operation and reached the level of the placebo group. We do not recommend prophylactic intravenous dexamethasone for the prevention of PDPH.

scholarly journals Efficacy and Safety of Prophylactic Intrathecal Normal Saline for Prevention of Post Dural Puncture Headache among Women Undergoing Cesarean Section under Spinal Anesthesia: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Semagn Abate ◽  
Siraj Ahmed ◽  
Getachew Mergia Anbese
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Dural Puncture ◽  
Controlled Trial ◽  
Intrathecal Injection ◽  
Repeated Measurements ◽  
Epidural Needle ◽  
Post Dural Puncture Headache ◽  
Resource Limited

Abstract Background: Post-Dural Puncture Headache is the commonest complication of spinal anesthesia. Body of evidence revealed that Conservative management failed to show significant benefit and epidural needle and catheter techniques didn’t provide conclusive evidence. On the other hand, intrathecal injection of normal saline is a simple technique and cost-effective in a resource-limited setup but it is not well examined on its effectiveness and safety profiles.Methods and materials: After Obtaining Ethical clearance from IRB, 152 mothers scheduled for cesarean section under spinal anesthesia were allocated randomly into two groups. Data analysis was done with SPSS version 22. Descriptive statistics were run to see the overall distribution of the study subjects. Unpaired student’s T-test for continuous symmetric data and Mann-Whitney U test for non-normally distributed data were used. Categorical data were analyzed with Chi-square and fisher’s exact test where appropriate. A generalized estimating equation model was used to investigate the interaction of repeated measurements of NRS pain scores of PDPH. Result: The overall incidence of PDPH was 29.6% while the proportion of patients who experienced PDPH was the highest among patients with control as compared to intervention( 36.8% vs 22%) respectively. The GEE model revealed that the NRS pain score was 0.7, 0.4, and 0.2 unit higher at 12, 24, and 48 respectively in control as compared to the interventionConclusion: prophylactic intrathecal normal saline could be an option in a resource-limited setup where the appropriate spinal needle is not accessible and management of moderate and severe PDPH is not feasibleRegistration: The protocol was registered prospectively in Clinical Trials.gov (NCT04393766).

Antishivering Effect of Low Dose Meperidine in Caesarean Section under Spinal Anesthesia: A Randomized Double-blind Placebo-controlled Trial

2013 ◽  
Vol 9 (5) ◽  
pp. 305-311 ◽  
Author(s):  
Hassan Zabetian ◽  
Abdolreza Sotoodeh Jahromi ◽  
Mohammad Yasin Karami ◽  
Mohamed Amin Ghobadifar
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Controlled Trial ◽  
Double Blind ◽  
Double Blind Placebo
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