Theophylline versus NSAID in the Treatment of Postdural Puncture Headache in Obstetric Patients
DOI:
https://doi.org/10.51253/pafmj.v74i3.7837Keywords:
Efficacy, NSAID, Oral Theophylline and Postdural puncture headacheAbstract
Objective: To determine the effectiveness of oral Theophylline compared to Non-Steroidal Anti-Inflammatory Drugs in the management of postdural puncture headache in obstetric patients.
Study Design: Quasi-experimental Study.
Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Kharian Pakistan, from Apr to Sep 2018.
Methodology: Our study enrolled 60 pregnant women suffering from postdural puncture headache. The were divided in to two groups, NSAID-Group (Group-A) who received 30mg of Ketorolac in three divided doses in 24 hours and Theophylline- Group (Group-B) who received 750mg of oral Theophylline in three divided doses in 24 hours after which effects of both drugs were noted.
Results: Pregnant women were enrolled in NSAID-Group and in Theophylline Group. Mean baseline Visual Analogue Scale score was 7.500±0.97 in NSAID-Group and 7.33±0.92 in Theophylline Group. Mean weight was 66.86±5.25 kg in NSAID-Group and 67.16±7.01 Kg in Theophylline-Group. In NSAID-Group efficacy was noted in 7(23.3%) patients as compared to 25(83.3%) patients in Theophylline-Group, (p<0.001).
Conclusion: Theophylline when given orally in the management of postdural puncture headache proved to be a superior alternative to NSAID medication.
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References
Veličković I, Pujic B, Baysinger CW, Baysinger CL. Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia. Front Med 2017: 4; 133. https://doi.org/10.3389/fmed.2017.00133
Mohammed E, El-Shal SM. Efficacy of different size quincke spinal needles in reduction of incidence of post-dural puncture headache (PDPH) in caesarean section (CS). Randomized controlled study. Egypt J Anaesth 2017; 33(1): 53-58.
Polizzi V, Formigoni P, Crusso C, Tribi L. Cerebrospinal Fluid Leak in Cochlear Implantation: Enlarged Cochlear versus Enlarged Vestibular Aqueduct (Common Cavity Excluded). Int J Otolaryngol 2016; 659: 84.
Shibli KU, Macachor JD. What works for the management of PDPH; is the current evidence enough? Anaesth Pain Intensive Care 2014; 18(2): 137-141.
Russell IF. A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour. Int J Obstet Anesth 2012; 21: 7-16.
Choi JS, Chang SJ. A Comparison of the Incidence of Post-Dural Puncture Headache and Backache After Spinal Anesthesia: A Pragmatic Randomized Controlled Trial. Worldviews Evid Based Nurs. 2018; 15(1): 45-53. https://doi.org/10.1111/wvn.12236
Puthenveettil N, Rajan S, Mohan A, et al. Sphenopalatine ganglion block for treatment of post-dural puncture headache in obstetric patients: An observational study. Indian J Anaesth 2018; 62(12): 972-977. https://doi.org/10.4103/ija.IJA_443_18
Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003; 91(5): 718-729.
Clark JW, Solomon GD, Senanayake PD. Substance P concentra-tion and history of headache in relation to post lumbar puncture headache: towards prevention. J Neurol Neurosurg Psychiatry 1996; 60: 681.
Ergun U, Say B, Ozer G. Intrvenous Theophylline decreases post-dural puncture headaches. J Clin Neurosci 2008; 15: 1102-1104.
https://doi.org/10.1016/j.jocn.2007.11.001
Kwak KH. Postdural puncture headache. Korean J Anesthesiol 2017; 70(2): 136-143. https://doi.org/10.4097/kjae.2017.70.2.136
Arevalo-Rodriguez I, Ciapponi A, Roqué i Figuls M, Muñoz L, et al. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev 2016; 3(3): CD009199.
https://doi.org/10.1002/14651858.CD009199.pub3
Zorrilla-Vaca A, Healy R, Zorrilla-Vaca C. Finer gauge of cutting but not pencil-point needles correlate with lower incidence of post-dural puncture headache: a meta-regression analysis. J Anesth 2016; 30: 855-863.
Bendel MA, Moeschler SM, Qu W. Treatment of Refractory Postdural Puncture Headache after Intrathecal Drug Delivery System Implantation with Epidural Blood Patch Procedures: A 20-Year Experience. Pain Res Treat 2016: 2134959.
https://doi.org/10.1155/2016/2134959
Akdere H, Burgazli KM. The Efficiency of Intravenous Theophylline on the Headache Which Occurs After Spinal Anesthesia. J Neurol Res 2011; 1: 190-192.
Hungs M, Schoen SW, Topper R, North J. Spontaneous intracranial hypotension: a rare cause of chronic headache. Fortschr Neurol Psychiatr 1999; 67(9): 387-390.
Singh N, Shreshtha AK, Thakur MS, Patra S. Xanthine scaffold: scope and potential in drug development. Heliyon. 2018; 4(10): e00829.
https://doi.org/10.1016/j.heliyon.2018.e00829
Mahoori A, Hassani E, Noroozinia H, Javaheri N, Hatami S. Theophylline versus acetaminophen in the treatment of post-dural puncture headache (PDPH). Middle East J Anaesthesiol 2013; 22(3): 289-292.
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