The impact of intravenous aminophylline on the prevention of post-dural puncture headache in cesarean section patients under spinal anesthesia

Abstract

Background: Orthostatic headache following spinal anesthesia is commonly caused by cerebrospinal fluid (CSF) leakage and a subsequent decrease in CSF pressure. Aim of the Study: This study aimed to evaluate the effect of intravenous aminophylline on the incidence of post-dural puncture headache (PDPH). Patients and Method: A double-blind, randomized clinical trial was conducted in the Obstetrics and Gynecology Department at Al-Yarmouk Teaching Hospital in Baghdad, Iraq. A total of 40 pregnant women scheduled for elective cesarean section under spinal anesthesia were enrolled and randomly divided into two groups. Group A (n=20) received aminophylline at a dose of 1 mg/kg diluted in 100 ml of 0.09% normal saline over 20 minutes, administered after placental extraction. Group B (n=20) received 100 ml of 0.09% normal saline over the same duration. All patients were assessed for headache occurrence at 1, 4, 24, and 48 hours postoperatively. Results: The incidence of PDPH was significantly lower in the aminophylline group compared to the control group. Only one patient in Group A developed a headache within the first 24 and 48 hours postoperatively, compared to seven patients in Group B. Conclusion: Intravenous aminophylline appears to be an effective measure for preventing post-dural puncture headache in patients undergoing cesarean section under spinal anesthesia.