Comparing the Effect of Paracetamol, Dexamethasone, and Paracetamol plus Dexamethasone on Prevention of Postoperative Headache in Pregnant Women Undergoing Cesarean Section with Spinal Anesthesia

This study aimed to compare the effect of paracetamol, dexamethasone, and paracetamol plus dexamethasone on prevention of postoperative headache in pregnant women undergoing cesarean section with spinal anesthesia.
In this clinical trial study, 220 pregnant women who were candidate for cesarean section under spinal anesthesia were randomly divided in 4 groups of 55 receiving 1 g paracetamol, 8 mg dexamethasone, 1 g paracetamol plus 8 mg dexamethasone, or the same volume of normal saline. The incidence of postoperative headache were compared between the 4 groups.
Findings: 6 hours after the operation, frequency of postoperative headache in the paracetamol, dexamethasone, paracetamol plus dexamethasone, and control groups was 23.60, 20.00, 10.90, and 40.00 percent, respectively (P = 0.004). 12 hours after the surgery, these amounts were 25.15, 20.00, 10.90, and 40.00 percent, respectively (P = 0.004); and 24 hours after the surgery, they were 21.80, 20.00, 10.90, and 34.50 percent, respectively (P = 0.027).
Using combination of paracetamol plus dexamethasone is more effective. Considering low effect of paracetamol for prevention of postoperative headache and also side-effects of high dose of dexamethasone, it seems that using combination of the two drugs is better for prevention of postoperative headache.