title: Oral multidose caffeine-paracetamol combination is not effective for the prophylaxis of postdural puncture headache.
abstract: OBJECTIVE
  To investigate the effects of different doses of oral caffeine-paracetamol combinations in postdural puncture headache (PDPH) prophylaxis.
  
  
  METHODS
  Prospective, randomized, placebo-controlled, blinded study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 210 ASA physical status I and II patients undergoing lower extremity surgery.
  
  
  METHODS
  Patients were randomly divided into 3 groups. One hour before the spinal anesthesia, the first group (n = 70) received placebo, the second group (n = 70) received 500-mg paracetamol + 75-mg caffeine, and the third group (n = 70) received 500-mg paracetamol + 125-mg caffeine orally. The same doses were repeated every 6 hours for 3 days. Patients were then interviewed on days 1, 2, 3, 4, and 7 to inquire about any PDPH. The interviewer was unaware of the PDPH prophylaxis group members. Patients who were discharged early were interviewed by telephone.
  
  
  RESULTS
  Postdural puncture headache occurred in 11 patients (15.7%) in group 1, 10 patients (% 14.28) in group 2, and 10 patients (% 14.28) in group 3. The differences between the groups were insignificant (P > .05). The complications due to spinal anesthesia were similar in the 3 groups. Side effects of caffeine such as lack of sleep, tachycardia, and hypertension were not observed in groups 2 or 3.
  
  
  CONCLUSIONS
  Prophylactic administration of paracetamol-caffeine combinations at the stated doses does not prevent PDPH.
authors.affiliation: Department of Anesthesia, University of Erciyes, Kayseri, Turkey. aliye@operamail.com
authors.forename: Aliye
authors.initials: A
authors.lastname: Esmaoglu
authors.forename: Hatice
authors.initials: H
authors.lastname: Akpinar
authors.forename: Fatih
authors.initials: F
authors.lastname: Uğur
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002110:Caffeine / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D004388:Dura Mater; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D013129:Spinal Puncture / Q000009:adverse effects*
chemical_list: D018712:Analgesics, Non-Narcotic; D000697:Central Nervous System Stimulants; D004338:Drug Combinations; D000082:Acetaminophen; D002110:Caffeine