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Anaesth Pain & Intensive Care. 2019; 23(2): 63-67

Role of prednisolone in management of post-Dural puncture headache (PDPH) after spinal anaesthesia in obstetrics patients

Nighat Afridi, Amna Fareed, Ambreen fatima, Saifullah Khan, ShahGul Khan.

Background and Aims:
PDPH is common cause of morbidity in patients underwent dural puncture for C-section. PDPH is benign mostly and leads to delayed headache management due to post-dural puncture (after spinal anesthesia) in patients undergoing C-section in tertiary care hospital.
An RCT (randomized controlled trial) study was conducted at department of gynecology and obstetrics, in Combined Military Hospital (CMH), Nowshera. Study duration was 6 months (April 2018-September 2018). 60 patients sample size was determined through WHO calculator. Patients were selected through non probability consecutive sampling. Ethical approval and consent forms were taken. Patients were categories into two groups (randomly). Group A was given oral prednisolone tablet while Group B was given placebo. Patients were followed for Visual analogue scale score measurement. Data was analyzed using SPSS version 24. T-Test and Chi-square test was applied. P value ≤0.05 was significant value after analysis.
Total 60 women undergone c sections were included in study. Mean age of women was 28.5 years±4.3SD. Mean pain scores were significantly reduced in prednisolone group as compared to placebo at 24, 48, 72 and 96 hours (p=0.00). Majority of patients in placebo group had severe headache as compare to oral prednisolone group after 96 hours (p=0.00).
Post-Dural Puncture Headache is a major complications following C-section in spinal anesthesia. Oral prednisolone usage is very effective in lowering severity of headache and duration of PDPH. Oral prednisolone also limits adverse events associated with PDPH after C-section performed in spinal anesthesia.

Key words: Prednisolone, Spinal anesthesia, Post-dural puncture

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