Clinical Comparative study of the effect of preoperative pregabalin on reduction of the incidence of headache after spinal anesthesia in cesarean section

Abstract

Background: Post dural puncture headache (PDPH) is unpleasant complication following dural puncture. Incidence of PDPH following dural puncture range from 0.3% to 20% in spinal anesthesia. The incidence rate of PDPH is related to age, gender, needle size, pregnancy and previous history of PDPH.PDPH is characterized by severe, dull non throbbing pain aggravated by sitting or erect position, coughing, sneezing or straining and diminished in supine position. Objective: To evaluate the effect of preoperative administration of oral pregabalin (150 mg) before cesarean section on the incidence of post dural puncture headache, postoperative nausea and vomiting and postoperative shivering, motor block, time to rescue analgesia, time of two segment regression and Apgar score of baby at 1 and 5 minute. Patients and Methods: A prospective randomized study that was done in Alazhar University Hospitals after approval of ethical committee, An informed consent was obtained from the patients. Results: The incidence of post dural puncture headache, postoperative nausea and vomiting and postoperative shivering were significantly lower at pregabalin groups. Time to rescue analgesia and time of two segment regression were significantly longer at pregabalin groups. Patients at pregabalin groups reach modified Bromage motor scale grade 3 earlier than patients at groups without pregabalin. Conclusion: Preoperative oral pregabalin 150 mg before cesarean section reduced the incidence of PDPH, postoperative nausea and vomiting and postoperative shivering, beside the earlier onset of motor block with increase duration of analgesia and time of two segment regression with no effect on baby.