Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache
Objective: Headache is not an uncommon complication of spinal anesthesia. The efficacy of intravenous (IV) hydrocortisone in treating the patients with postdural puncture headache was observed in this study. Materials and Methods: Sixty patients with headache following spinal anesthesia were randoml...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2012-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=190;epage=193;aulast=Alam |
| _version_ | 1818941621641674752 |
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| author | Md Rabiul Alam Md Aminur Rahman Reza Ershad |
| author_facet | Md Rabiul Alam Md Aminur Rahman Reza Ershad |
| author_sort | Md Rabiul Alam |
| collection | DOAJ |
| description | Objective: Headache is not an uncommon complication of spinal anesthesia. The efficacy of intravenous (IV) hydrocortisone in treating the patients with postdural puncture headache was observed in this study.
Materials and Methods: Sixty patients with headache following spinal anesthesia were randomly allocated into two groups. Thirty patients received only conventional therapy (recumbent positioning, IV or oral hydration, analgesics with caffeine, stool softeners, and soft diet) plus 2 ml of normal saline IV (placebo) 8 hourly for 48 h. Thirty other patients received conventional therapy plus hydrocortisone IV (100 mg in 2 ml 8 hourly for 48 h). Headache intensity was measured using visual analogue scale.
Results: No significant difference was observed in baseline headache intensity between the two groups (P = 0.6642) before beginning of treatment. After 6 h, the mean headache intensity in patients treated conventionally was 6.02 ± 2.46, while it was 2.06 ± 1.98 in other patients who received additional hydrocortisone IV (P < 0.0001). After 24 h, headache intensity was 3.77 ± 1.85 in conventionally treated group versus 0.94 ± 2.67 in hydrocortisone group (P < 0.0001), while it was 1.95 ± 1.12 in conventionally treated group versus 0.69 ± 1.64 in hydrocortisone group (P = 0.001) after 48 h.
Conclusions: Very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. However, its clear mechanism of action is yet to be determined. Large-scale studies are recommended to consider the steroid therapy as a standard treatment for postdural puncture headache. |
| first_indexed | 2024-12-20T06:58:27Z |
| format | Article |
| id | doaj.art-91d5dc3dc2d34fbbaeadac6b57764c08 |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-12-20T06:58:27Z |
| publishDate | 2012-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-91d5dc3dc2d34fbbaeadac6b57764c082022-12-21T19:49:16ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852012-01-0128219019310.4103/0970-9185.94840Role of very short-term intravenous hydrocortisone in reducing postdural puncture headacheMd Rabiul AlamMd Aminur RahmanReza ErshadObjective: Headache is not an uncommon complication of spinal anesthesia. The efficacy of intravenous (IV) hydrocortisone in treating the patients with postdural puncture headache was observed in this study. Materials and Methods: Sixty patients with headache following spinal anesthesia were randomly allocated into two groups. Thirty patients received only conventional therapy (recumbent positioning, IV or oral hydration, analgesics with caffeine, stool softeners, and soft diet) plus 2 ml of normal saline IV (placebo) 8 hourly for 48 h. Thirty other patients received conventional therapy plus hydrocortisone IV (100 mg in 2 ml 8 hourly for 48 h). Headache intensity was measured using visual analogue scale. Results: No significant difference was observed in baseline headache intensity between the two groups (P = 0.6642) before beginning of treatment. After 6 h, the mean headache intensity in patients treated conventionally was 6.02 ± 2.46, while it was 2.06 ± 1.98 in other patients who received additional hydrocortisone IV (P < 0.0001). After 24 h, headache intensity was 3.77 ± 1.85 in conventionally treated group versus 0.94 ± 2.67 in hydrocortisone group (P < 0.0001), while it was 1.95 ± 1.12 in conventionally treated group versus 0.69 ± 1.64 in hydrocortisone group (P = 0.001) after 48 h. Conclusions: Very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. However, its clear mechanism of action is yet to be determined. Large-scale studies are recommended to consider the steroid therapy as a standard treatment for postdural puncture headache.http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=190;epage=193;aulast=AlamCorticosteroidsheadachehydrocortisonepostdural puncture headachespinal anesthesia |
| spellingShingle | Md Rabiul Alam Md Aminur Rahman Reza Ershad Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache Journal of Anaesthesiology Clinical Pharmacology Corticosteroids headache hydrocortisone postdural puncture headache spinal anesthesia |
| title | Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache |
| title_full | Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache |
| title_fullStr | Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache |
| title_full_unstemmed | Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache |
| title_short | Role of very short-term intravenous hydrocortisone in reducing postdural puncture headache |
| title_sort | role of very short term intravenous hydrocortisone in reducing postdural puncture headache |
| topic | Corticosteroids headache hydrocortisone postdural puncture headache spinal anesthesia |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=190;epage=193;aulast=Alam |
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