Caffeine, Is it effective for prevention of postdural puncture headache in young adult patients?

Background and objectives: Postdural puncture headache is a relatively common complication in spinal anesthesia, so several kinds of regimens have been suggested for treatment of this problem. The aim of this study was to evaluate the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for prevention of postdural puncture headache (PDPH) in young adult patients received spinal anesthesia. Methods: One hundred ASA I and II patients undergoing elective knee surgeries either arthroscopy or anterior cruciate ligament reconstruction (ACL reconstruction) were included in this study. Patients were randomized by double-blind, placebo-controlled design to receive intravenously (IV) either 10 mL normal saline as control group (group S) or 10 ml with 500 mg caffeine sodium benzoate (CSB) as caffeine group (group C) during the first 60 min after spinal anesthesia administration. The patient's electrocardiogram, noninvasive blood pressure, and pulse oximetry were monitored and recorded. The patients' headaches were evaluated by using the visual analog scale (VAS), and the severity of the headache was classified as follows: no headache = 0, mild headache 63, moderate headache from 4 to 6 and severe headache >= 7. Analgesic requirements were recorded. 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 (2 patients). Analgesic demand was significantly lower in group C than in group S. Conclusion: It seems that the incidence of postdural puncture headache decreases in those patients who received caffeine sodium benzoate. The article can potentially help clinicians to use caffeine as an effective drug for prevention of PDPH. (C) 2013 Production and hosting by Elsevier B. V. on behalf of Egyptian Society of Anesthesiologists. Open access under CC BY-NC-ND license.