BACKGROUND AND OBJECTIVES: In this study, we evaluated the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for postdural puncture headaches (PDPH) on patients administered spinal anesthesia. METHODS:Sixty ASA I and II patients undergoing lower abdominal or lower extremity surgery were included in this study. Patients were randomized by double-blind, placebo-controlled design to receive either 1,000 mL normal saline with 500 mg caffeine sodium benzoate (group C) or 1,000 mL normal saline (group S) during the first 90 minutes after spinal anesthesia administration. The patient's electrocardiogram, non-invasive blood pressure, and pulse oximetry were monitored and recorded. The patients' headaches were evaluated by using the visual analog scale (VAS). At the end of the fifth day, the severity of the headache was classified as follows: no headache = 0; mild headache = 1; moderate headache = 2; severe headache = 3. Analgesic requirements were recorded for 5 days. RESULTS:Visual analog scale scores were significantly lower in group C than in group S. The incidence of moderate and severe headache was significantly higher in group S (11 patients) when compared with group C (3 patients). Analgesic demand was significantly lower in group C than in group S for 4 days. CONCLUSION:Intravenous caffeine sodium benzoate administration during spinal anesthesia is a simple and safe way to minimize PDPH.
RCT Entities:
BACKGROUND AND OBJECTIVES: In this study, we evaluated the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for postdural puncture headaches (PDPH) on patients administered spinal anesthesia. METHODS: Sixty ASA I and II patients undergoing lower abdominal or lower extremity surgery were included in this study. Patients were randomized by double-blind, placebo-controlled design to receive either 1,000 mL normal saline with 500 mg caffeine sodium benzoate (group C) or 1,000 mL normal saline (group S) during the first 90 minutes after spinal anesthesia administration. The patient's electrocardiogram, non-invasive blood pressure, and pulse oximetry were monitored and recorded. The patients' headaches were evaluated by using the visual analog scale (VAS). At the end of the fifth day, the severity of the headache was classified as follows: no headache = 0; mild headache = 1; moderate headache = 2; severe headache = 3. Analgesic requirements were recorded for 5 days. RESULTS: Visual analog scale scores were significantly lower in group C than in group S. The incidence of moderate and severe headache was significantly higher in group S (11 patients) when compared with group C (3 patients). Analgesic demand was significantly lower in group C than in group S for 4 days. CONCLUSION: Intravenous caffeine sodium benzoate administration during spinal anesthesia is a simple and safe way to minimize PDPH.
Authors: Phillip E Vlisides; Duan Li; Amy McKinney; Joseph Brooks; Aleda M Leis; Graciela Mentz; Alexander Tsodikov; Mackenzie Zierau; Jacqueline Ragheb; Daniel J Clauw; Michael S Avidan; Giancarlo Vanini; George A Mashour Journal: Anesth Analg Date: 2021-07-01 Impact factor: 6.627