Esmaoglu Aliye, Akpinar Hatice, Uğur Fatih
Department of Anesthesia, University of Erciyes, Kayseri, Turkey.
J Clin Anesth. 2005 Feb;17(1):58-61. doi: 10.1016/j.jclinane.2004.04.003.
To investigate the effects of different doses of oral caffeine-paracetamol combinations in postdural puncture headache (PDPH) prophylaxis.
Prospective, randomized, placebo-controlled, blinded study.
University hospital.
A total of 210 ASA physical status I and II patients undergoing lower extremity surgery.
Patients were randomly divided into 3 groups. One hour before the spinal anesthesia, the first group (n = 70) received placebo, the second group (n = 70) received 500-mg paracetamol + 75-mg caffeine, and the third group (n = 70) received 500-mg paracetamol + 125-mg caffeine orally. The same doses were repeated every 6 hours for 3 days. Patients were then interviewed on days 1, 2, 3, 4, and 7 to inquire about any PDPH. The interviewer was unaware of the PDPH prophylaxis group members. Patients who were discharged early were interviewed by telephone.
Postdural puncture headache occurred in 11 patients (15.7%) in group 1, 10 patients (% 14.28) in group 2, and 10 patients (% 14.28) in group 3. The differences between the groups were insignificant (P > .05). The complications due to spinal anesthesia were similar in the 3 groups. Side effects of caffeine such as lack of sleep, tachycardia, and hypertension were not observed in groups 2 or 3.
Prophylactic administration of paracetamol-caffeine combinations at the stated doses does not prevent PDPH.
探讨不同剂量口服咖啡因 - 对乙酰氨基酚组合预防硬膜穿刺后头痛（PDPH）的效果。
前瞻性、随机、安慰剂对照、双盲研究。
大学医院。
总共210例接受下肢手术的ASA身体状况I级和II级患者。
患者随机分为3组。在脊髓麻醉前1小时，第一组（n = 70）接受安慰剂，第二组（n = 70）口服500毫克对乙酰氨基酚 + 75毫克咖啡因，第三组（n = 70）口服500毫克对乙酰氨基酚 + 125毫克咖啡因。相同剂量每6小时重复一次，共3天。然后在第1、2、3、4和7天对患者进行访谈，询问是否有PDPH。访谈者不知道PDPH预防组的成员。提前出院的患者通过电话进行访谈。
第一组11例患者（15.7%）发生硬膜穿刺后头痛，第二组10例患者（14.28%），第三组10例患者（14.28%）。组间差异无统计学意义（P > 0.05）。3组脊髓麻醉的并发症相似。在第二组和第三组中未观察到咖啡因的副作用，如失眠、心动过速和高血压。
按规定剂量预防性给予对乙酰氨基酚 - 咖啡因组合不能预防PDPH。
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