Comparative Study between the Effect of Intravenous versus Intrathecal Dexamethasone on Post Dural Puncture Headache in Cesarean Section Surgeries

Abstract Background One of the main objectives of anesthesia is to alleviate the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for decreasing incidence of post operative side effect like PDPH. Objective To compare the efficacy of intrathecal dexamethasone with intravenous dexamethasone in the prevention of post dural puncture headache in spinal anesthesia in cesarean section surgeries. Patients and Methods We performed our study on 75 patients divided into 3groups (control group, IT group, IV group) respectively the first group25 patients had classic spinal, the second group 25 patients had classic spinal and 2ml (8mg) dexamethasone intravenously and the third group had spinal anesthesia with 0.5ml (2mg) dexamethasone intrathecally. All patients observed for 48hrs for occurrence of headache (PDPH) after excluded other types of headache. The incidence, severity, onset and duration of the headache assessed. Results The results revealed that there was significantly difference between the groups in incidence, Severity, onset and duration of PDPH. There was a statistically significant higher frequency of headache in control group was 10 patients (40%), followed by IV group was 7 patients (28%), then IT group was 3 patients (12%). As well as a statistically significant higher frequency of severe headache in control group, while there is no severe headache in IT group and IV group,). The results shows a statistically significant higher mean value of duration “hrs.” of headache in control group was 22.29±11.87, followed by IV group and IT group was (12.00±0.00 and 12.86±8.07) respectively. Conclusion This study showed that use of dexamethasone decrease the incidence and duration of PDPH. As There was a statistically significant higher frequency of headache in control group, followed by IV group then IT group. As well as a statistically significant higher frequency of severe headache in control group, while there was no severe headache in IT group and IV group, The results showed that duration of headache in control group was higher, followed by IV group and IT group respectively.