Fennelly M, Galletly D C, Purdie G I
Department of Anaesthesia, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Anesth Analg. 1991 Apr;72(4):449-53. doi: 10.1213/00000539-199104000-00006.
This study examined the hypothesis that headache after general anesthesia is related to a caffeine withdrawal state. Two hundred eighty-seven patients undergoing minor elective procedures under general anesthesia were studied. Four to six hours after anesthesia each patient completed a questionnaire assessing his or her own alcohol, tobacco, and caffeine consumption, and the occurrence of postoperative side effects. A highly significant difference was found between the caffeine consumption of patients with and without preoperative (P = 0.0035) and postoperative (P less than 0.0001) headache. Logistic regression analysis of trend between headache and caffeine consumption suggested that with each 100-mg increase in caffeine consumption, there was a 12% increase in the odds of headache developing in the immediate preoperative period (P less than 0.0066) and a 16% increase in the odds of postoperative headache developing (P less than 0.0001). No relationship was found between headache and the patients' age, sex, usual frequency of headache, consumption of alcohol or nicotine, or the anesthetic agents or adjuvants used. It is concluded that postoperative headache is related to caffeine intake and that this relationship is explained, at least in part, by a perioperative caffeine withdrawal syndrome.
本研究检验了全身麻醉后头痛与咖啡因戒断状态有关这一假设。对287例接受全身麻醉下小型择期手术的患者进行了研究。麻醉后4至6小时，每位患者完成一份问卷，评估其自身的酒精、烟草和咖啡因摄入量，以及术后副作用的发生情况。术前（P = 0.0035）和术后（P < 0.0001）有头痛和无头痛患者的咖啡因摄入量之间存在高度显著差异。头痛与咖啡因摄入量之间趋势的逻辑回归分析表明，咖啡因摄入量每增加100毫克，术前即刻发生头痛的几率增加12%（P < 0.0066），术后发生头痛的几率增加16%（P < 0.0001）。未发现头痛与患者年龄、性别、通常头痛频率、酒精或尼古丁摄入量，或所用麻醉剂或佐剂之间存在关联。得出的结论是，术后头痛与咖啡因摄入有关，并且这种关系至少部分地由围手术期咖啡因戒断综合征来解释。
