Evaluation of intravenous hydrocortisone in reducing headache after spinal anesthesia: a double blind controlled clinical study [corrected].
BACKGROUND
Headache after spinal anesthesia is a common complication is patients undergoing this procedure. In this study we evaluated the efficacy of intravenous hydrocortisone in the treatment of headache after spinal anesthesia in women who have undergone cesarean section.


METHODS
Sixty patients with headache after spinal anesthesia were included. Patients randomly allocated into two groups, 30 patients received only conventional therapy (complete bed rest, hydration, acetaminophen and pethidine). Other 30 patients received conventional therapy plus intravenous hydrocortisone (200 mg first, then 100 mg TID for 48 hours). Mean (+/- SD) of headache intensity at 0, 6, 24, and 48 hours after beginning of treatment was measured using visual analog scale.


RESULTS
There was no significant difference in headache intensity between two groups before beginning of treatment. After 6 hours, the mean of headache intensity in 30 patients treated conventionally was 6.63 (+/- 1.35) while it was 2.77 (+/- 1.07) in other patients received intravenous hydrocortisone too (p <0.001). After 24 hours, mean headache intensity was 3.87 (+/- 1.63) in conventionally treated group versus 0.73 (+/- 0.74) in hydrocortisone group (p <0.001). After 48 hours, mean headache intensity was 1.87 (+/- 0.93) in conventionally treated group versus 0.63 (+/- 0.61) in hydrocortisone group (p = 0.001).


CONCLUSIONS
This study showed the therapeutic effects of intravenous hydrocortisone in reducing headache after spinal anesthesia in women who underwent cesarean section. Its mechanism of action is yet to be determined.
Noyan Ashraf
M A
MA
Imam Khomeini General Hospital, Tehran University of Medical Sciences, Tehran, Iran. ocrt@tums.ac.ir
Sadeghi
A
A
Azarbakht
Z
Z
Salehi
S
S
Hamediseresht
E
E
D000082:Acetaminophen / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000775:Anesthesia, Spinal / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002585:Cesarean Section; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008614:Meperidine / Q000008:administration & dosage; D010147:Pain Measurement / Q000379:methods; D051299:Post-Dural Puncture Headache / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D012146:Rest; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D000082:Acetaminophen; D008614:Meperidine; D006854:Hydrocortisone