The Efficacy of Prophylactic Intravenous Aminophylline, Paracetamol or Aminophylline and Paracetamol in Prevention of Headache Strikes Due to Spinal Anesthesia in Cesarean Sections Compared to the Control Group

Post-dural-puncture headache (PDPH) is commonly seen after neuroaxial block and several types of regimens have been suggested for treatment. This study aimed to evaluate the effects of aminophylline, paracetamol and administration of aminophylline and paracetamol concurrently on prevention of post-dural-puncture headache.
In a double-blind randomized clinical trial, we evaluated 136 patients in four groups (n = 34) undergoing spinal anesthesia for elective cesarean section in Shahid Beheshti and Alzahra hospitals of Isfahan province, Iran, during March to December 2015. After umbilical cord clamping, in four group aminophylline (1.5 mg/kg), paracetamol (12.5 mg/kg), aminophylline and paracetamol with the same dose and normal saline was injected slowly intravenously. Before spinal anesthesia, each 15 minutes during execute time of surgery and in recovery room, every 6 hours in first day and daily in first weak after the surgery, incidence of post-dural-puncture headache in each group was evaluated.
Findings: 42 patients (33.88%) out of the 136 ones suffered from headache. 26.5% of patients who had received aminophylline, 32.4% of patients who had received paracetamol, 14.7% of patients who had received aminophylline and paracetamol and 50% of patients who had not received any drug suffered from headache (P = 0.007).
This study shows that intravenous administration of aminophylline and paracetamol significantly reduces the incidence of post-dural-puncture headache in cesarean section and we can use this regimen for prevention.