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Pregabalin Versus Hydrocortisone for Postdural Puncture Headache After Spinal for Cesarean

Phase 4
Completed
Conditions
Post-Dural Puncture Headache
Interventions
Registration Number
NCT03910088
Lead Sponsor
Cairo University
Brief Summary

Postdural puncture headache (PDPH) is a common complication after spinal anesthesia. The role of pregabalin and hydrocortisone in the treatment of PDPH is unclear. The aim of this work is to assess and compare the efficacy of both drugs in severe cases of PDPH after spinal anesthesia for elective cesarean section.

Detailed Description

The study will be done on 30 patient with PDPH with VAS score ≥ 5 after spinal anesthesia for elective cesarean section. Patients will be divided into three groups: Control group (group C):will receive conventional treatment in the form of good oral hydration, 500 mg of acetaminophen plus 65 mg of caffeine oral tablets thrice daily, 3 cups of coffee daily, 50 mg of diclofenac potassium oral tablets twice daily and recumbent positioning for 48 hours. Pregabalin group (group P): will receive the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours. Hydrocortisone group (group H): will receive the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours. The three groups will be compared regarding the headache intensity using a visual analog scale.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
30
Inclusion Criteria
  • Patients who underwent elective cesarean section under spinal anesthesia.
  • Patients aged 18 to 40 years old.
  • Patients classified as ASA I or II.
Exclusion Criteria
  • Patients with known sensitivity to any of the used drugs.
  • Patients classified as ASA III or more.
  • Preeclampsia.
  • Patients with a history of chronic headache or migraine Patients receiving pregabalin for chronic pain.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PregabalinPregabalin 100Mg Oral Capreceived the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours
control grouporal fluidsreceived conventional treatment in the form of good oral hydration, 500 mg of acetaminophen plus 65 mg of caffeine oral tablets thrice daily, 3 cups of coffee daily, 50 mg of diclofenac potassium oral tablets twice daily and recumbent positioning for 48 hours
Hydrocortisoneoral fluidsreceived the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours.
Pregabalinoral fluidsreceived the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours
PregabalinCaffeinereceived the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours
control groupCaffeinereceived conventional treatment in the form of good oral hydration, 500 mg of acetaminophen plus 65 mg of caffeine oral tablets thrice daily, 3 cups of coffee daily, 50 mg of diclofenac potassium oral tablets twice daily and recumbent positioning for 48 hours
control groupAcetaminophenreceived conventional treatment in the form of good oral hydration, 500 mg of acetaminophen plus 65 mg of caffeine oral tablets thrice daily, 3 cups of coffee daily, 50 mg of diclofenac potassium oral tablets twice daily and recumbent positioning for 48 hours
control groupDiclofenacreceived conventional treatment in the form of good oral hydration, 500 mg of acetaminophen plus 65 mg of caffeine oral tablets thrice daily, 3 cups of coffee daily, 50 mg of diclofenac potassium oral tablets twice daily and recumbent positioning for 48 hours
HydrocortisoneAcetaminophenreceived the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours.
HydrocortisoneHydrocortisonereceived the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours.
PregabalinAcetaminophenreceived the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours
PregabalinDiclofenacreceived the conventional treatment plus 100 mg of pregabalin oral tablet every 8 hours for 48 hours
HydrocortisoneCaffeinereceived the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours.
HydrocortisoneDiclofenacreceived the conventional treatment plus 100 mg of hydrocortisone IV every 8 hours for 48 hours.
Primary Outcome Measures
NameTimeMethod
Assessment of pain using Visual Analogue Scalethe first 48 hours following treatment

Headache intensity after 1 minute in upright position using the Visual Analogue Scale for pain assessment ranging from 0 to 10, with zero means no pain and 10 is the worst pain after 48 hours of treatment

Secondary Outcome Measures
NameTimeMethod
Assessment of the amount of rescue drugThe first 48 hours following treatment

Total dose of nalbuphine given in each group..

incidence of side effects of the studied drugthe first 48 hours following treatment

incidence of Somnolence

incidence of side effect of the studied drugthe first 48 hours following treatment

incidence of dizziness

Trial Locations

Locations (1)

Cairo University

🇪🇬

Cairo, Zamalek, Egypt

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