Effect of prophylactic gabapentin on post-dural puncture headache in patients after cesarean section surgery

Post-dural puncture headache (PDPH) is the most common complication of spinal anesthesia. Numerous drugs have been proposed to prevent or treat post spinal headache, but no definitive treatment is still available. Gabapentin has widely been used for prophylaxis or treatment of different types of headache, so in this study, the preventive effect of gabapentin on PDPH after cesarean section surgery was evaluated.

100 eligible pregnant women candidate for elective cesarean section were evaluated in this prospective double blind randomized study in two groups: intervention (gabapentin 600 milligram, n=50) and control (placebo, n=50). Patients received oral medications two hours before performing the spinal anesthesia and were followed up for three days after surgery, asked about the occurrence and severity of headache, analgesic consumption and any complications like drowsiness or vertigo..

Two study groups were similar in terms of age, gestational age, height and weight (P>0.05). The overall incidence of headache in the intervention group (6%, N=3) was significantly lower than the control group (20%, n=10) (P<0.05). The prevalence of analgesic consumption in the intervention group (n=0) was markedly lower than control group (12%, n=6) (P=0.01). In addition, the severity of headache was less in the intervention group in the third follow-up day (P<0.05). No significant complications like vertigo and drowsiness were observed in both groups

Gabapentin was an effective and safe drug for preventing post-dural puncture headache and reducing its severity after spinal anesthesia in cesarean section surgery. It should be considered as part of a multimodal approach to prevent PDPH.