• Aliye Esmaoglu, Hatice Akpinar, and Fatih Uğur.
• Department of Anesthesia, University of Erciyes, Kayseri, Turkey. aliye@operamail.com
• J Clin Anesth. 2005 Feb 1; 17 (1): 58-61.

Study ObjectivesTo investigate the effects of different doses of oral caffeine-paracetamol combinations in postdural puncture headache (PDPH) prophylaxis.DesignProspective, randomized, placebo-controlled, blinded study.SettingUniversity hospital.PatientsA total of 210 ASA physical status I and II patients undergoing lower extremity surgery.InterventionsPatients were randomly divided into 3 groups. One hour before the spinal anesthesia, the first group (n = 70) received placebo, the second group (n = 70) received 500-mg paracetamol + 75-mg caffeine, and the third group (n = 70) received 500-mg paracetamol + 125-mg caffeine orally. The same doses were repeated every 6 hours for 3 days. Patients were then interviewed on days 1, 2, 3, 4, and 7 to inquire about any PDPH. The interviewer was unaware of the PDPH prophylaxis group members. Patients who were discharged early were interviewed by telephone.Measurements And Main ResultsPostdural puncture headache occurred in 11 patients (15.7%) in group 1, 10 patients (% 14.28) in group 2, and 10 patients (% 14.28) in group 3. The differences between the groups were insignificant (P > .05). The complications due to spinal anesthesia were similar in the 3 groups. Side effects of caffeine such as lack of sleep, tachycardia, and hypertension were not observed in groups 2 or 3.ConclusionsProphylactic administration of paracetamol-caffeine combinations at the stated doses does not prevent PDPH.

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