Study the Effect of Intravenous Infusion of Dexamethasone versus Magnesium Sulphate on Incidence and severity of Post Dural Puncture Headache in Parturient Undergoing Caesarean Section

Elattar, Hala Abdel- Sadek; Ahmed, Amany Fouad; Elmahallawy, Hadeer Emad Ali; Aamer, Reham Mohamed Mohamed

doi:10.21608/ejhm.2022.272497

Study the Effect of Intravenous Infusion of Dexamethasone versus Magnesium Sulphate on Incidence and severity of Post Dural Puncture Headache in Parturient Undergoing Caesarean Section

Document Type : Original Article

Authors

10.21608/ejhm.2022.272497

Abstract

Background: Cerebrospinal fluid (CSF) leaks from the subarachnoid space, causing the CSF volume and pressure to drop which exerts traction on the intracranial pain-sensitive structures and leads to post-dural puncture headache (PDPH). Objective: Modulation of PDPH in parturient undergoing cesarean section using intravenous infusion of dexamethasone versus magnesium sulfate. Subjects and Methods: Prospective, randomized, controlled, double-blind, clinical study included 72 pregnant women undergoing spinal anesthesia for elective cesarean sections and were allocated into three groups at random. 24 patients per group: Group C: patient received 100ml IV infusions of normal saline over 20 minutes after clamping of the umbilical cord, Group D: patient received dexamethasone 0.1 mg/kg IV infusion diluted in normal saline with a total volume of 100 ml over 20 minutes beyond clamping of the umbilical cord, Group M: cases received 50mg/kg magnesium sulfate IV infusion diluted in normal saline with total volume 100ml over 20minutes beyond umbilical cord clamping. Incidence and severity of PDPH were recorded at 6,12,24,36.48,60&72 postoperatively. Results: In comparison to the control group dexamethasone significantly reduce the incidence of PDPH. Both dexamethasone and magnesium sulfate significantly lowered the severity of PDPH in comparison to the control group without any significant difference between the two groups without side effects.
Conclusion: It has been demonstrated using intravenous dexamethasone in pregnant women who have undergone cesarean section with spinal anesthesia reduces the frequency and severity of PDPH. While intravenous magnesium sulfate just reduces the intensity of headache with no adverse effects.

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