Archives of Anesthesiology and Critical Care 2016. 2(2):189-192.

Effect of Intravenous Meperidine in Controlling Post Dural Puncture Headache
Mohammad Reza Kamranmanesh, Homayoun Aghamohammadi, Alireza Jafari, Yassaman Amini, Babak Gharaei

Abstract


Background: Spinal anesthesia is usually applied for urologic surgeries. Postdural puncture headache (PDPH) is among common complications which has not been reduced during last years despite all advances in the field of medicine. Therapeutic effects of conventional therapy (paracetamol and novaphen) are being compared to intravenous meperidine in patients suffering from PDPH.

Methods: One hundred patients, with PDPH following spinal anesthesia for transurethral lithotripsy were enrolled and randomly allocated to receive conventional (group C) or intravenous meperidine (group P) (20 mg every 5min up to 120mg or when the pain was decreased to less than 3/10).

Results: Time interval to reach acceptable headache was 3 hours in group P compared to 8 hours in group C. Group P patients received statistically significantly less amount of paracetamol and novaphen, and experienced fewer episodes of severe headaches in 48 hours after the start of treatment, compared to group C.

Conclusion: Short term intravenous meperidine compared to conventional therapy resulted in more rapid and effective outcomes.


Keywords


meperidine; acetaminophen; post-dural puncture headache

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References


Thomas SR, Jamieson DR, Muir KW. Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture. BMJ. 2000; 321(7267):986–90.

Vallejo MC, Mandell GL, Sabo DP, Ramanathan S. Postdural puncture headache: a randomized comparison of five spinal needles in obstetric patients. Anesth Analg. 2000; 91(4):916–20.

Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003; 91(5):718-29.

Bateman RJ, Morris JC. Factors Contributing to the Post-Lumbar Puncture Headache. JAMA Neurol. 2015; 72(7):835.

Robert L. Frank, MD, FAAEM, Lumbar Puncture and Post-Dural Puncture Headaches: Implications for the Emergency Physician. J Emerg Med. 2008; 35(2):149-157.

Barbosa FT. [Post-dural headache with seven months duration: case report]. Rev Bras Anestesiol. 2011; 61(3):355–9.

Jabbari A, Alijanpour E, Mir M, Bani Hashem N, Rabiea SM, Rupani MA.Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors. Caspian J Intern Med. 2013; 4(1):595-602.

Choi T-LP. Management of Postdural puncture headache. Techniq reg anesth pain. 2001; 5(1):41-5.

Wight JM, Kalidindi R. Management of post-dural puncture headache in late pregnancy before the onset of labour. Int J Obstet Anesth. 2016; 25:92-3.

Gharaei B, Jafari A, Aghamohammadi H, Kamranmanesh M, Poorzamani M, Elyassi H, edt al. Opioid-sparing effect of preemptive bolus low-dose ketamine for moderate sedation in opioid abusers undergoing extracorporeal shock wave lithotripsy: a randomized clinical trial. Anesth Analg. 2013; 116 (1), 75-80.

Boonmak P, Boonmak S. Epidural blood patching for preventing and treating post-dural puncture headache. Cochrane Database Syst Rev. 2010; (1):CD001791.

Williams EJ, Beaulieu P, Fawcett WJ, Jenkins JG. Efficacy of epidural blood patch in the obstetric population. Int J Obstet Anesth. 1999; 8(2):105-9.

Kurz M, Belani K, Sessler DI, Kurz A, Larson MD, Schroeder Mm, et al. Naloxone, meperidine, and shivering. Anesthesiology. 1993; 79(6):1193-201.

Basurto Ona X, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for treating post-dural puncture headache. Cochrane Database Syst Rev. 2011; (8):CD007887.

Basurto Ona X, Osorio D, Bonfill Cosp X. Drug therapy for treating post-dural puncture headache. Cochrane Database Syst Rev. 2015; 7:CD007887.

Huseyinoglu U, Huseyinoglu N, Hamurtekin E, Aygun H, Sulu B. Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture. J Clin Neurosci. 2011; 18(10):1365-8.

Rachinger-Adam B, Kraft E, Luchting B, Woehrle T, Hasbargen U, Krueger W, et al. Treatment of refractory post-dural puncture headache with low doses of the strong opioid piritramide. Br J Anaesth. 2013; 110(3):490-1.

Williamson DJ, Shepheard SL, Cook DA, Hargreaves RJ, Hill RG, Cumberbatch MJ. Role of opioid receptors in neurogenic dural vasodilation and sensitization of trigeminal neurones in anaesthetized rats. Br J Pharmacol. 2001; 133(6):807-14.

Wrobel M, Volk T. Post-dural puncture headache. Anesth Pain Med. 2012; 1(4):273-4.


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