Background and Goal of Study: Post dural puncture headache is a complication of puncture of the dura mater. (1) The headache was related to excessive loss of cerebrospinal fluid (2) An epidural blood patch remains the standard treatment for a PDPH, pain relief from an EBP is often immediate.(2) Gabapentin (Neurontin; Pfizer) reported to be effective in treatment of spinal headaches. It has complications such as somnolence, ataxia, dizziness and visual disturbances.(3) Pregabalin is an anticonvulsant drug used for neuropathic pain and as an adjunct therapy for partial seizures.The treatment of oral gabapentin and pregablin, caused a significant decrease in headache severity(4,5).
Materials and Methods: In this study, Sixty ASA I-II patients who developed PDPH after spinal anaesthesia were enrolled. both patients group were randomised to receive either gabapentin (Group 1) or pregabalin (Group 2). Group 1 (n=30) received 900mg/day,and Group 2 (n=30) received 150mg/ day g orally.
Results and Discussion: Both groups have the same demographic findings. NRS (numeric rating scale) system used to evaluate analgesic property of drugs. NRS were significantly lower in Group 2 than in Group 1. In first group NRS before treatment was 7.90 with SD=0.71 and 4.33 and SD=0.74 (p< 0.001) after receiving drug. In second group NRS before treatment was 8.1with SD=0.75 and 2.16 and SD=0.74 (p< 0.001) after therapy.
Conclusion(s): Administration of oral gabapentin and pregabalin in patients with PDPH is an effective and safe treatment to post spinal headache, but pregabalin is more effective than gabapentin.
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2. Safa-Tisseront V, Thormann F, Malassiné P, et al. (August 2001).Effectiveness of epidural blood patch in the management of post-dural puncture headache. Anesthesiology 95 (2): 334-9.
3. D. Dogan Erol.The effect of oral gabapentin on postdural puncture headache,Acute Pain, Volume 8, Issue 4, Pages 169-173
4. Beyazit Zencirci. Postdural puncture headache and pregabalinJournal of Pain Research, February 2010, Volume 2010:3 Pages 11 14
5. Lin YT, Sheen MJ, Huang ST, Horng HC, Cherng CH, Wong CS, Hot ST. Gabapentin relieves post-dural puncture headache—a report of two casesActa Anaesthesiol Taiwan. 2007 Mar;45(1):47-51