Abstract |
The effect of dexamethasone on post-dural puncture headache (PDPH) after spinal anesthesia has not been well elucidated. This randomized, double-blind, placebo-controlled trial was carried out in patients undergoing a cesarean at the Qilu Hospital, Shandong University. The subjects were randomly divided into a placebo and a dexamethasone group. The incidences of PDPH on the first, second, third and seventh postoperative day were studied, and the severity of PDPH was assessed using a visual analog scale. Studies in PubMed, Embase and the Cochrane Library database were searched and included in the present meta-analysis. Summary estimates of weighted mean differences and 95 % confidence intervals (CIs) were obtained using random-effects models. We included 307 participants in the dexamethasone group and 309 in the placebo group for analysis. The results indicated that prophylactic administration of 8 mg dexamethasone did not have any protective effect against PDPH (31 vs. 18, P = 0.054) and even increased the incidence of PDPH in the first 24 h in parturient patients (25 vs. 11, P = 0.016). Furthermore, the meta-analysis also showed that dexamethasone did not prevent the incidence of PDPH in the postoperative follow-up days (RR 1.05; 95 % CI 0.46-2.38; P = 0.91) and may even have increased the trend in the first 24 h. Prophylactic administration of 8 mg dexamethasone does not have any protective effect against PDPH and may even increase the incidence of PDPH in the first 24 h in patients with spinal anesthesia.
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Authors | Bo Yang, Dong-Liang Li, Ping Dong, Xi-Yan Zhang, Li Zhang, Jin-Gui Yu |
Journal | Acta neurologica Belgica
(Acta Neurol Belg)
Vol. 115
Issue 1
Pg. 59-67
(Mar 2015)
ISSN: 2240-2993 [Electronic] Italy |
PMID | 24865592
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents
- Dexamethasone
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Topics |
- Adult
- Anesthesia, Spinal
(adverse effects)
- Anti-Inflammatory Agents
(therapeutic use)
- Databases, Factual
(statistics & numerical data)
- Dexamethasone
(therapeutic use)
- Double-Blind Method
- Female
- Humans
- Incidence
- Male
- Meta-Analysis as Topic
- Post-Dural Puncture Headache
(drug therapy, epidemiology, etiology)
- Visual Analog Scale
- Young Adult
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