Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial
Background and purpose: The most common method of anesthesia in Cesarean section is spinal anesthesia (SA). Post-Dural puncture headache (PDPH) is one of the complications of SA. The aim of this study was to evaluate the effect of intravenous administration of atropine and neostigmine in prevention...
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| Format: | Article |
| Language: | English |
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Mazandaran University of Medical Sciences
2023-01-01
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| Series: | Journal of Mazandaran University of Medical Sciences |
| Subjects: | |
| Online Access: | http://jmums.mazums.ac.ir/article-1-18561-en.pdf |
| _version_ | 1827698672239902720 |
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| author | Hamidreza Shetabi Mitra Jabalameli Reihanak Talakkoub Amir Mansuri |
| author_facet | Hamidreza Shetabi Mitra Jabalameli Reihanak Talakkoub Amir Mansuri |
| author_sort | Hamidreza Shetabi |
| collection | DOAJ |
| description | Background and purpose: The most common method of anesthesia in Cesarean section is spinal anesthesia (SA). Post-Dural puncture headache (PDPH) is one of the complications of SA. The aim of this study was to evaluate the effect of intravenous administration of atropine and neostigmine in prevention of PDPH following Cesarean section.
Materials and methods: This study was performed in 62 candidates of elective Cesarean section with SA in Isfahan Shahid Beheshti Hospital. Patients were randomly assigned into the two groups (n= 31 per group) using Random Allocation Software. After umbilical cord clamping, experimental group received neostigmine 0.5 mg and atropine 0.5 mg (i.v.), while the control group received 10 ml i.v. infusion of normal saline. The incidence and severity of headache were compared between the two groups in the first 48 hours and followed up for one week.
Results: In this study, one patient in experimental group (3.2%) and five patients in control group (16.1%) reported PDPH which can be clinically important (P=0.195). Headache was seen in two patients (1 in each group) at recovery and in four at ward in control group (P=0.11). The mean severity of headache was 5 and 4.2±0.45 in experimental group and control group, respectively (P= 0.18). The interval between spinal anesthesia and first onset of headache was one hour in experimental group and 20.8 ± 11.1 hours in control group (P=0.18).
Conclusion: According to the present study, the neostigmine (0.5mg) + atropine (0.5mg) is associated with a non- significant reduction in the incidence of headache and its severity after spinal anesthesia that are clinically important.
(Clinical Trials Registry Number: IRCT20210324050762N1) |
| first_indexed | 2024-03-10T13:34:29Z |
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| id | doaj.art-062d7fa1a50947b195b28318071f48a7 |
| institution | Directory Open Access Journal |
| issn | 1735-9260 1735-9279 |
| language | English |
| last_indexed | 2024-03-10T13:34:29Z |
| publishDate | 2023-01-01 |
| publisher | Mazandaran University of Medical Sciences |
| record_format | Article |
| series | Journal of Mazandaran University of Medical Sciences |
| spelling | doaj.art-062d7fa1a50947b195b28318071f48a72023-11-21T07:39:55ZengMazandaran University of Medical SciencesJournal of Mazandaran University of Medical Sciences1735-92601735-92792023-01-01322168896Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical TrialHamidreza Shetabi0Mitra Jabalameli1Reihanak Talakkoub2Amir Mansuri3 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Medical Student, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Background and purpose: The most common method of anesthesia in Cesarean section is spinal anesthesia (SA). Post-Dural puncture headache (PDPH) is one of the complications of SA. The aim of this study was to evaluate the effect of intravenous administration of atropine and neostigmine in prevention of PDPH following Cesarean section. Materials and methods: This study was performed in 62 candidates of elective Cesarean section with SA in Isfahan Shahid Beheshti Hospital. Patients were randomly assigned into the two groups (n= 31 per group) using Random Allocation Software. After umbilical cord clamping, experimental group received neostigmine 0.5 mg and atropine 0.5 mg (i.v.), while the control group received 10 ml i.v. infusion of normal saline. The incidence and severity of headache were compared between the two groups in the first 48 hours and followed up for one week. Results: In this study, one patient in experimental group (3.2%) and five patients in control group (16.1%) reported PDPH which can be clinically important (P=0.195). Headache was seen in two patients (1 in each group) at recovery and in four at ward in control group (P=0.11). The mean severity of headache was 5 and 4.2±0.45 in experimental group and control group, respectively (P= 0.18). The interval between spinal anesthesia and first onset of headache was one hour in experimental group and 20.8 ± 11.1 hours in control group (P=0.18). Conclusion: According to the present study, the neostigmine (0.5mg) + atropine (0.5mg) is associated with a non- significant reduction in the incidence of headache and its severity after spinal anesthesia that are clinically important. (Clinical Trials Registry Number: IRCT20210324050762N1)http://jmums.mazums.ac.ir/article-1-18561-en.pdfspinal anesthesiacesarean sectionheadacheneostigmineatropine |
| spellingShingle | Hamidreza Shetabi Mitra Jabalameli Reihanak Talakkoub Amir Mansuri Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial Journal of Mazandaran University of Medical Sciences spinal anesthesia cesarean section headache neostigmine atropine |
| title | Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial |
| title_full | Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial |
| title_fullStr | Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial |
| title_full_unstemmed | Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial |
| title_short | Effect of Intravenous Administration of Atropine-Neostigmine in Prevention of Headache after Spinal Anesthesia in Cesarean Section: A Randomized Clinical Trial |
| title_sort | effect of intravenous administration of atropine neostigmine in prevention of headache after spinal anesthesia in cesarean section a randomized clinical trial |
| topic | spinal anesthesia cesarean section headache neostigmine atropine |
| url | http://jmums.mazums.ac.ir/article-1-18561-en.pdf |
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