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Intravenous Administration of Caffeine Sodium Benzoate for Postdural Puncture Headache
  1. Ayşen Yücel, M.D.*,
  2. Süleyman Özyalçin, M.D.,
  3. Gül K. Talu, M.D.,
  4. Elif C. Yücel, M.D. and
  5. Serdar Erdine, M.D.
  1. From the Departments of Algology and Anesthesiology, Medical Faculty of Istanbul, Istanbul, Turkey.
  1. Reprint requests: Ayşen Yücel, M.D., Department of Algology, Medical Faculty of Istanbul, Istanbul University, Monoblok Çapa Klinikleri, 34390 Çapa, Istanbul, Turkey.


Background and Objectives In this study, we evaluated the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for postdural puncture headaches (PDPH) on patients administered spinal anesthesia.

Methods Sixty ASA I and II patients undergoing lower abdominal or lower extremity surgery were included in this study. Patients were randomized by double-blind, placebo-controlled design to receive either 1,000 mL normal saline with 500 mg caffeine sodium benzoate (group C) or 1,000 mL normal saline (group S) during the first 90 minutes after spinal anesthesia administration. The patient's electrocardiogram, non-invasive blood pressure, and pulse oximetry were monitored and recorded. The patients' headaches were evaluated by using the visual analog scale (VAS). At the end of the fifth day, the severity of the headache was classified as follows: no headache = 0; mild headache = 1; moderate headache = 2; severe headache = 3. Analgesic requirements were recorded for 5 days.

Results Visual analog scale scores were significantly lower in group C than in group S. The incidence of moderate and severe headache was significantly higher in group S (11 patients) when compared with group C (3 patients). Analgesic demand was significantly lower in group C than in group S for 4 days.

Conclusion Intravenous caffeine sodium benzoate administration during spinal anesthesia is a simple and safe way to minimize PDPH. Reg Anesth Pain Med 1999: 24: 51–54.

  • postdural puncture headache
  • caffeine sodium benzoate
  • spinal anesthesia.

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