THE EFFECT OF INTRAVENOUS HYDROCORTISONE IN REDUCING POST SPINAL HEADACHE

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NOUYAN ASHRAF M.A.; SADEGHI S.A.; AZAR BAKHT Z.; SALEHI SALEH; HAMEDISERESHT E.

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Journal: JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE Year:2005 | Volume:27 | Issue:50 Page(s): 54-61

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Title

THE EFFECT OF INTRAVENOUS HYDROCORTISONE IN REDUCING POST SPINAL HEADACHE

Author(s)

Keywords

PDPHQ3

SPINAL ANESTHESIAQ3

HEADACHEQ4

HYDROCORTISONEQ3

CORTIOSTEROIDSQ3

Abstract

Background: HEADACHE after SPINAL ANESTHESIA is a complication of dural puncture that occurs in varying degrees in patients undergoing this procedure. Symptomatic and conventional treatments are complete bed rest, hydration, and analgesics. Epidural blood patch is the only definitive but invasive therapy. In this randomized clinical trial we evaluated the efficacy of intravenous HYDROCORTISONE in postdural puncture HEADACHE in women who received SPINAL ANESTHESIA for cesarean section. Material and Methods: 60 patients with HEADACHE after SPINAL ANESTHESIA were included in the study. Patients with previous history of HEADACHE such as migraine, cluster HEADACHE, and preeclampsia were excluded. After obtaining informed consent, 30 patients randomly received conventional therapy (complete bed rest, hydration, acetaminophen codeine and pethidine) while other 30 patients received intravenous HYDROCORTISONE (200 mg first, then 100mg TDS for 2 days) in addition to the above drug. Mean (±SD) HEADACHE intensity was measured using visual analog scale. At the beginning of therapy and 6, 24 and 48 hours later. Results: There was no significant difference in HEADACHE intensity between the two groups before beginning of treatment. After 6 hours, the mean of HEADACHE intensity in 30 patients treated conventionally was 6.63 (± 1.35) while it was 2.77 (± 1.07) in other patients who received intravenous HYDROCORTISONE too (p<0.001). After 24 hours, mean HEADACHE intensity was 3.87 (±1.63) in conventionally treated group versus 0.73 (±0.74) in HYDROCORTISONE group (p<0.001). After 48 hours, mean HEADACHE intensity was 1.87 (±0.93) in conventionally treated group versus 0.63 (±0.61) in HYDROCORTISONE group (p=0.001). Conclusion: This study showed the efficacy of intravenous HYDROCORTISONE in reducing HEADACHE after SPINAL ANESTHESIA in women who underwent cesarean section. However, further studies are needed to consider steroid therapy as a standard treatment for postural puncture HEADACHE and further investigations are needed to determine true mechanism of action of steroids in pain management.

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APA: Copy

NOUYAN ASHRAF, M.A., SADEGHI, S.A., AZAR BAKHT, Z., SALEHI, SALEH, & HAMEDISERESHT, E.. (2005). THE EFFECT OF INTRAVENOUS HYDROCORTISONE IN REDUCING POST SPINAL HEADACHE. JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE, 27(50), 54-61. SID. https://sid.ir/paper/63362/en

Vancouver: Copy

NOUYAN ASHRAF M.A., SADEGHI S.A., AZAR BAKHT Z., SALEHI SALEH, HAMEDISERESHT E.. THE EFFECT OF INTRAVENOUS HYDROCORTISONE IN REDUCING POST SPINAL HEADACHE. JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE[Internet]. 2005;27(50):54-61. Available from: https://sid.ir/paper/63362/en

IEEE: Copy

M.A. NOUYAN ASHRAF, S.A. SADEGHI, Z. AZAR BAKHT, SALEH SALEHI, and E. HAMEDISERESHT, “THE EFFECT OF INTRAVENOUS HYDROCORTISONE IN REDUCING POST SPINAL HEADACHE,” JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE, vol. 27, no. 50, pp. 54–61, 2005, [Online]. Available: https://sid.ir/paper/63362/en

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