对乙酰氨基酚和咖啡因对剖腹产脊髓麻醉后硬膜穿刺头痛的预防效果:随机双盲临床试验。

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Iranian Journal of Medical Sciences Pub Date : 2024-09-01 DOI:10.30476/ijms.2023.99577.3166
Seyed Mohammad Reza Hadavi, Ashkan Panah, Sona Shamohammadi, Fatemeh Kanaani Nejad, Mohammad Ali Sahmeddini, Naeimehossadat Asmarian
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引用次数: 0

摘要

背景:硬膜穿刺后头痛(PDPH)是接受剖宫产手术的产妇在脊髓麻醉后最常见的并发症。本研究旨在评估对乙酰氨基酚和咖啡因预防 PDPH 的效果:这项双盲随机临床试验的对象是 96 名产科妇女,她们都是择期剖腹产手术的候选者。将参与者随机分为两组,干预组参与者服用对乙酰氨基酚(500 毫克)+ 咖啡因(65 毫克)片剂,对照组参与者在脊髓麻醉诱导前 2 小时口服安慰剂片剂,手术后每 6 小时口服一次,直至 24 小时。所有产妇在术后 24 小时前每 6 小时接受一次 PDPH 频率和强度评估,然后在术后 48 小时和 72 小时接受评估。对产后 72 小时内的总体满意度进行评估。数据使用 SPSS 软件进行分析。结果干预组的参与者在脊髓麻醉后出现 PDPH 的可能性降低了 70%(OR=0.31 P=0.01,95% CI [0.12-0.77])。18小时、48小时和72小时后,他们的头痛症状也明显减轻。干预组的参与者在研究结束时的满意度更高(P=0.01)。没有与干预相关的副作用报告:结论:预防性服用对乙酰氨基酚+咖啡因可降低 70% 的 PDPH 风险,并显著减轻剖宫产脊髓麻醉产科患者的疼痛强度。
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The Prophylactic Effect of Acetaminophen and Caffeine on Post Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Double-Blind Clinical Trial.

Background: Post-dural puncture headache (PDPH) is the most common complication following spinal anesthesia among parturients undergoing cesarean section surgery. The purpose of this study was to evaluate the effectiveness of acetaminophen and caffeine in preventing PDPH.

Methods: This double-blind, randomized clinical trial was conducted on 96 obstetric women, who were candidates for elective cesarean section. Following the randomization of participants into two groups, participants in the intervention group received tablets of acetaminophen (500 mg)+caffeine (65 mg), and participants in the control group received placebo tablets orally 2 hours before spinal anesthesia induction and then every 6 hours after surgery up to 24 hours. All parturients were evaluated for frequency and intensity of PDPH every 6 hours until 24 hours after surgery and then 48 and 72 hours after surgery. Overall satisfaction during the first 72 hours of postpartum was evaluated. The data were analyzed using SPSS software. P<0.05 was considered statistically significant.

Results: Participants in the intervention group were 70% less likely to experience PDPH after spinal anesthesia (OR=0.31 P=0.01, 95% CI [0.12-0.77]). They also experienced significantly milder headaches 18 hours, 48 hours, and 72 hours later. Participants in the intervention group reported higher levels of satisfaction at the end of the study (P=0.01). No side effects related to the intervention were reported.

Conclusion: Prophylactic administration of acetaminophen+caffeine decreases 70% the risk of PDPH and significantly attenuates pain intensity in obstetric patients who underwent spinal anesthesia for cesarean section.

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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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