Yücel A, Ozyalçin S, Talu G K, Yücel E C, Erdine S
Department of Algology, Medical Faculty of Istanbul, Turkey.
Reg Anesth Pain Med. 1999 Jan-Feb;24(1):51-4.
In this study, we evaluated the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for postdural puncture headaches (PDPH) on patients administered spinal anesthesia.
Sixty ASA I and II patients undergoing lower abdominal or lower extremity surgery were included in this study. Patients were randomized by double-blind, placebo-controlled design to receive either 1,000 mL normal saline with 500 mg caffeine sodium benzoate (group C) or 1,000 mL normal saline (group S) during the first 90 minutes after spinal anesthesia administration. The patient's electrocardiogram, non-invasive blood pressure, and pulse oximetry were monitored and recorded. The patients' headaches were evaluated by using the visual analog scale (VAS). At the end of the fifth day, the severity of the headache was classified as follows: no headache = 0; mild headache = 1; moderate headache = 2; severe headache = 3. Analgesic requirements were recorded for 5 days.
Visual analog scale scores were significantly lower in group C than in group S. The incidence of moderate and severe headache was significantly higher in group S (11 patients) when compared with group C (3 patients). Analgesic demand was significantly lower in group C than in group S for 4 days.
Intravenous caffeine sodium benzoate administration during spinal anesthesia is a simple and safe way to minimize PDPH.
在本研究中,我们评估了对接受脊髓麻醉的患者预防性静脉注射苯甲酸钠咖啡因治疗硬膜外穿刺后头痛(PDPH)的疗效和安全性。
本研究纳入了60例接受下腹部或下肢手术的美国麻醉医师协会(ASA)分级为I级和II级的患者。患者通过双盲、安慰剂对照设计随机分组,在脊髓麻醉给药后的前90分钟内,一组接受含500mg苯甲酸钠咖啡因的1000mL生理盐水(C组),另一组接受1000mL生理盐水(S组)。监测并记录患者的心电图、无创血压和脉搏血氧饱和度。使用视觉模拟量表(VAS)评估患者的头痛情况。在第五天结束时,将头痛严重程度分类如下:无头痛=0;轻度头痛=1;中度头痛=2;重度头痛=3。记录5天内的镇痛需求。
C组的视觉模拟量表评分显著低于S组。S组(11例患者)中度和重度头痛的发生率显著高于C组(3例患者)。C组的镇痛需求在4天内显著低于S组。
脊髓麻醉期间静脉注射苯甲酸钠咖啡因是一种简单且安全的方法,可将PDPH的发生降至最低。