Gabapentin relieves post-dural puncture headache--a report of two cases.
Post-dural puncture headache (PDPH) is a vexing problem of the patients following spinal anesthesia or a complication relative to inadvertent dural puncture in epidural anesthesia. The prevention and management of PDPH contain a laddered forestallment and therapy with varying results. The anticonvulsant gabapentin has been reported to be effective in prophylaxis and treatment of headaches. We report here two cases of PDPH, who failed to respond to traditional analgesics, but had good response to gabapentin. After treatment with gabapentin 400 mg three times daily, the headache was relieved remarkably in 24 hr. Discussions of the pathophysiology of PDPH, pharmacological actions of gabapentin, and possible mechanisms of action of gabapentin on PDPH are brought forward in the text.
Lin
Yao-Tsung
YT
Department ofAnesthesiology, Armed Forces Taichung General Hospital, Taichung, Taiwan, ROC.
Sheen
Michael J
MJ
Huang
Shun-Tsung
ST
Horng
Huei-Chi
HC
Cherng
Chen-Hwan
CH
Wong
Chih-Shung
CS
Hot
Shung-Tai
ST
D000328:Adult; D000588:Amines / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D051299:Post-Dural Puncture Headache / Q000188:drug therapy* / Q000209:etiology; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin