Effect of Hydrocortisone on Reducing severity of Post Dural Puncture Headache after Spinal Anesthesia for Elective Caesarean Section

Abstract

Spinal anesthesia is frequently used in pregnant female undergoing caesarean section due to its safety than general anaesthesia. Post dural puncture headache (PDPH) is commonly occurring problem associated with spinal anaesthesia and causes a considerable morbidity. PDPH depends on several factor and various methods have been used to reduce and treat the pain of PDPH. We evaluated effects of hydrocortisone on the treatment of PDPH in obstetrical patient. To compare mean decrease in Visual Analogue Scalepain score in patients who developed PDPH after elective caesarean section under spinal anaesthesia who were given conventional treatment versus conventional treatment plus hydrocortisone. Double blind randomized control trial. Study conducted in department of anaesthesia and obstetrics of Allama Iqbal Medical College, Jinnah hospital (tertiary care) conducted from13th June 2014 to 13th December 2014. Sample size was calculated 60 (30 each) cases using 95% confidence interval, 80% power of test. Patients who developed PDPH after spinal anaesthesia for elective caesarean section were divided into 2 group; Group A (Conventional Treatment) and Group B, (Conventional Treatment plus Hydrocortisone 100mg 8 hourly for 48 hours). Details were recorded regarding age; mean pretreatment and post treatment VAS after 6 hours. Mean decrease in pain VAS score was 3.30 + 1.2 in group A while 7.17+ 1.3 in group B. (P value 0.001). Intravenous hydrocortisone is more effective in reducing post dural puncture headache pain severity after spinal anaesthesia for elective caesarean section when given along with conventional treatment as compared to conventional treatment alone.