Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarea...

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Main Authors: Walid Hamed Nofal, Mohamed Sidky Mahmoud, Azza Atef Abd Al Alim
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2014-01-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=359;epage=363;aulast=Nofal
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author Walid Hamed Nofal
Mohamed Sidky Mahmoud
Azza Atef Abd Al Alim
author_facet Walid Hamed Nofal
Mohamed Sidky Mahmoud
Azza Atef Abd Al Alim
author_sort Walid Hamed Nofal
collection DOAJ
description Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placebo. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl. Babies were followed up by Apgar scores, umbilical artery blood gases, breastfeeding difficulties, and need for NICU admission. The mothers were followed up for any side-effects of gabapentin for 24 h. Patients with PDPH were re-admitted and onset and duration of the headache were reported and severity was assessed using a visual analog scale (VAS) for 4 days from diagnosis. Paracetamol with caffeine and diclofenac were given for treatment, and the doses were adjusted according to VAS; also number of doses given for each group was recorded. Results: Eighty eight patients were randomized, and 2 were excluded. The incidence of headache and co-existing symptoms were similar in both groups. The onset of headache was significantly delayed in gabapentin group (P < 0.05). Also, severity and duration of headache were significantly less in gabapentin group (P < 0.05). The incidence of sedation was more in gabapentin group 11 (26.19%) versus placebo group 3 (6.81%). Neonatal outcomes were statistically insignificant between both groups. Conclusion: Pre-operative administration of gabapentin has no effect on incidence of (PDPH) but delays its onset and reduces its severity and duration in parturients undergoing cesarean section with spinal anesthesia without significant adverse effects on the mother or the baby.
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spelling doaj.art-9612f99472764d0d9bd9cacbc47aeb752022-12-21T19:08:53ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2014-01-018335936310.4103/1658-354X.136433Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?Walid Hamed NofalMohamed Sidky MahmoudAzza Atef Abd Al AlimBackground: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placebo. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl. Babies were followed up by Apgar scores, umbilical artery blood gases, breastfeeding difficulties, and need for NICU admission. The mothers were followed up for any side-effects of gabapentin for 24 h. Patients with PDPH were re-admitted and onset and duration of the headache were reported and severity was assessed using a visual analog scale (VAS) for 4 days from diagnosis. Paracetamol with caffeine and diclofenac were given for treatment, and the doses were adjusted according to VAS; also number of doses given for each group was recorded. Results: Eighty eight patients were randomized, and 2 were excluded. The incidence of headache and co-existing symptoms were similar in both groups. The onset of headache was significantly delayed in gabapentin group (P < 0.05). Also, severity and duration of headache were significantly less in gabapentin group (P < 0.05). The incidence of sedation was more in gabapentin group 11 (26.19%) versus placebo group 3 (6.81%). Neonatal outcomes were statistically insignificant between both groups. Conclusion: Pre-operative administration of gabapentin has no effect on incidence of (PDPH) but delays its onset and reduces its severity and duration in parturients undergoing cesarean section with spinal anesthesia without significant adverse effects on the mother or the baby.http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=359;epage=363;aulast=NofalGabapentinzPDPHspinal anesthesia
spellingShingle Walid Hamed Nofal
Mohamed Sidky Mahmoud
Azza Atef Abd Al Alim
Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
Saudi Journal of Anaesthesia
Gabapentinz
PDPH
spinal anesthesia
title Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
title_full Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
title_fullStr Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
title_full_unstemmed Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
title_short Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?
title_sort does preoperative gabapentin affects the characteristics of post dural puncture headache in parturients undergoing cesarean section with spinal anesthesia
topic Gabapentinz
PDPH
spinal anesthesia
url http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=359;epage=363;aulast=Nofal
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AT azzaatefabdalalim doespreoperativegabapentinaffectsthecharacteristicsofpostduralpunctureheadacheinparturientsundergoingcesareansectionwithspinalanesthesia