Comparison of the Effect of Gabapentin, Pregabalin and Acetaminophen in Post-Dural Puncture Headache

One of most common methods of anesthesia is neuraxial block that spinal anesthesia is one of such methods. One of the most common and debilitating complications of spinal anesthesia is Post-Dural Puncture Headache. As epidural blood patch is an invasive procedure and its performance needs expertise and some patients are not satisfied with its results، so we decided to perform a study aim at comparing the effects of Gabapentin، Pregabalin، and Acetaminophen on the treatment of post-dural puncture headache.

This prospective single-blind randomized clinical trial was conducted on 90 patients who underwent elective surgery under spinal anesthesia in Imam Khomeini hospital، Urmia، Iran in 2012 and suffered from post-dural puncture headache. The patients were randomly allocated into three groups. A bag containing one of the medications (gabapentin، pregabalin، and acetaminophen) and instructions for their use was given to each patient. Patient''s headache was evaluated with visual analog scale at the onset of the headache، 24، 48، and 72 hours after that. Data were analyzed with SPSS software version 16، chi-square and ANOVA tests. P value less than 0. 05 was considered significant.

The mean of visual analog scale values were less in pregabalin group than gabapentin group at all stages of drug administration and in gabapentin group was less than acetaminophen group (p<0. 05).

Both pregabalin and gabapentin are safe and effective medications for the treatment of post-dural puncture headache. 72-hour treatment with pregabalin if it immediately use after the onset of headache with complementary therapies، is the most effective treatment for post-dural puncture headache.