Prospective randomized study of role of Inj. adrenocorticotropic hormone (Inj. Acth) in post dural puncture headache of the patients undergone lower segement cesaerian section

Abstract

Aim: Evaluate the efficacy, hemodynamic effects and other side effects of inj. ACTH in the treatment of post dural puncture headache of the patients undergone. Material and Methods Place of study: Maruti Hospital Trichy, Time of study: 2016-to -2018 80 patients undergone lower segment cesarean section (LSCS) of ASA status I & II, aged between 20-40 years, who developed post spinal headache after spinal anaesthesia are included in our study They were assigned into any of the two groups – on the randomized basis. Group a patients were assigned to receive INJ. ACTH 25 IU im and group p patients an injection of placebo 0.3ml Normal saline in two doses in 24 hour interval. Observation: It has been observed that the patients in both groups had similar demographic datas in respect to age, height, weight, distribution and also duration of the surgery and similar perioperative events. In Acth group within two hour of the injection, patients got significant relief and with the second dose of the injection complete relief occurred in majority of the patients at 72 hours in placebo group no such reduction in the headache score seen even after receiving tab. paracetamol. Conclusion: 86% of the patients in acth group have got complete relief from the headache at 72 hours compared to the 64% in the placebo group. There is some mild increase in the mean arterial pressure in the inj. Acth group and no change in pulse rate or respiratory rate between these two groups. There is virtually no side effects with the use of inj. Acth in post dural puncture headache.