Ergün Ufuk, Say Bahar, Ozer Gokhan, Tunc Tugba, Sen Murat, Tüfekcioglu Senem, Akin Umit, Ilhan Mustafa N, Inan Levent
Department of Neurology, Ministry of Health, Ankara Training and Research Hospital, Nilgün Sok. 4/3, Farabi, Cankaya, 06550 Ankara, Turkey.
J Clin Neurosci. 2008 Oct;15(10):1102-4. doi: 10.1016/j.jocn.2007.11.001. Epub 2008 Jul 23.
Post-dural puncture headache (PDPH) is a common complication of lumbar puncture. As invasive treatments for PDPH have known complications, pharmacologic management may be preferable. The aim of this study was to evaluate and to compare the efficacy of intravenous theophylline treatment for PDPH, in comparison with a placebo. We found that intravenous theophylline infusion was effective for decreasing the painfulness of PDPH compared with the control group. The mean visual analogue scale (VAS) value was 7.05+/-1.47 before the theophylline infusion and 2.88+/-2.31 after infusion. An average of 59.1% relief of pain was obtained in the group treated with theophylline infusion. The improvement in VAS in the study group was significant (p < 0.001), whereas that in the control group was not (p = 0.15). The mean VAS decrease after theophylline infusion was 4.17+/-2.03 in the study group and 0.41+/-0.71 in the control group; the difference in improvement between the groups was significant (p < 0.001). Intravenous theophylline infusion is an easy, rapid, minimally invasive, an effective treatment for PDPH. It may be attempted in PDPH patients before invasive techniques are used. To the best of our knowledge, this is the first report on the effect of intravenous infusion of theophylline compared with a placebo in the treatment of PDPH.
腰穿后头痛（PDPH）是腰椎穿刺的常见并发症。由于针对PDPH的侵入性治疗存在已知并发症，药物治疗可能更为可取。本研究的目的是评估并比较静脉注射氨茶碱治疗PDPH与安慰剂的疗效。我们发现，与对照组相比，静脉输注氨茶碱可有效减轻PDPH的疼痛程度。氨茶碱输注前视觉模拟量表（VAS）的平均评分为7.05±1.47，输注后为2.88±2.31。氨茶碱输注治疗组平均疼痛缓解率为59.1%。研究组VAS评分的改善具有显著性（p<0.001），而对照组则无显著性差异（p = 0.15）。研究组氨茶碱输注后VAS评分平均下降4.17±2.03，对照组为0.41±0.71；两组改善情况的差异具有显著性（p<0.001）。静脉输注氨茶碱是一种简便、快速、微创且有效的PDPH治疗方法。在采用侵入性技术之前，可尝试用于PDPH患者。据我们所知，这是首篇关于静脉输注氨茶碱与安慰剂治疗PDPH效果对比的报告。
