Effects of Dexamethasone on Post-dural Puncture Headache in Patients Undergoing Orthopedic Surgery
Hadis Barkhori1, Farhad Arefi2, Kiavash Hushmandi3, Salman Daneshi4, Jafar Salehi5, *, Hamideh Barkhori6, Hamid Rafee7, Mehdi Raei8, Leila Karimi9
Article Information
Identifiers and Pagination:
Year: 2020Volume: 13
First Page: 42
Last Page: 46
Publisher ID: TOPAINJ-13-42
DOI: 10.2174/1876386302013010042
Article History:
Received Date: 15/07/2020Revision Received Date: 24/08/2020
Acceptance Date: 08/09/2020
Electronic publication date: 20/11/2020
Collection year: 2020
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
The effect of Dexamethasone on Post-Dural Puncture Headache (PDPH) after spinal anesthesia has not been well elucidated. The aim of the current study was to evaluate the effect of prophylactic intravenous dexamethasone on the incidence and severity of PDPH in patients undergoing orthopedic surgery.
Methods:
This randomized, double-blind, placebo-controlled trial was carried out in patients undergoing orthopedic surgery. The subjects were randomly divided into a placebo (n=140) and a dexamethasone (n=140) group. During the surgery, the control group participants were injected 2cc of distilled water, and the dexamethasone group participants were injected 2cc (8mg) of dexamethasone as an infusion in the veins. The incidences of PDPH on the first, third and seventh postoperative days were studied. Data were analyzed using SPSS version 22.
Results:
A total of 280 patients with a mean age of 32.7 ± 11.0 years were studied. The incidence of PDPH on the first day of post-operative period was lower in the dexamethasone group than the control group (21 vs. 34, P<0.05). This difference was disappeared on days 3 and 7. Nausea or vomiting occurred less in the dexamethasone group (9 vs. 26, P<0.05). However, no statistically significant association was found between study groups and the incidence of back pain (P>0.05).
Conclusion:
Although the frequency of PDPH was less in patients receiving dexamethasone, the incidence increased days after the operation and reached the level of the placebo group. We do not recommend prophylactic intravenous dexamethasone for the prevention of PDPH.
