Background: Post-dural puncture headache (PDPH) is one of the most common complications of lumbar punctures performed for spinal anaesthesia, neurologic investigation or inadvertent Dural puncture during Epidural anaesthesia. Despite acceptance of the postulated cause of CSF leakage and intracranial hypotension, the exact mechanism of developing PDPH is not clear. Many pharmacological options have been advocated as a therapy for PDPH with a varying degree of success, but problem in choosing main drug therapy is the lack of large randomized controlled trials proving efficacy and safety.
Aim of the Work: To compare the efficacy of aminophylline compared to acetaminophen in management of PDPH.
Patients and Methods: The current clinical trial included 70 patients aged between 18-40 years old, class I-II according to the American society of anaesthesiology having a headache that developed after Dural puncture for various surgical procedures under regional anaesthesia. Patients were randomly allocated into 2 groups (35 patients each). Patients in the study Group (A) received 250 mg Aminophylline IV infusion while patients in Group (B) received 1gm paracetamol IV infusion for management of PDPH. Baseline VAS scores were recorded before drug administration &at 2 hours, 6 hours and 12 hours after the treatment administration.
Results: Mean VAS scores for PDPH intensity were statistically significant lower in Group A compared to Group B at 2 hours, 6 hours & 12 hours, while baseline VAS Score for PDPH intensity was insignificant statistically between Both Groups. There was also statistically significant improvement in Group A compared to Group B according to the Patient Global impression of change (PGIC) between both groups.
Conclusion: IV injection of aminophylline is relatively straightforward and non-invasive, safe and effective treatment for PDPH, and has improved early-stage effectiveness.