Drug therapy for treating post-dural puncture headache.

Study answer

What this study found

Overall, caffeine showed benefit for treating post-dural puncture headache, including lower persistence of headache and reduced need for additional intervention. In one caffeine trial, headache persistence was 5/20 versus 18/21 with control (RR 0.29, 95% CI 0.13 to 0.64). Gabapentin, hydrocortisone, and theophylline reduced pain severity, and theophylline also increased the likelihood of reported pain improvement versus conservative treatment at 8 h (RR 1.95, 95% CI 1.27 to 3.01), 16 h (RR 2.25, 95% CI 1.29 to 3.92), and 24 h (RR 3.00, 95% CI 1.51 to 5.95). Sumatriptan, ACTH, pregabalin, and…

Study & population

Systematic review and meta-analysis of 13 randomized studies with 479 participants who had post-dural puncture headache after lumbar puncture or spinal or epidural procedures.

Intervention

This review evaluated multiple pharmacologic regimens for post-dural puncture headache, generally compared with placebo or conservative treatment.

Key limitation

The evidence base was limited by small trials, heterogeneous interventions and outcomes, short follow-up, and risk of bias.

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Original abstract