Aminophylline Versus Acetaminophen in the Treatment of Post-Dural Puncture Headache

Fawaz, Ahmed Ali; El-Gendy, Hanaa A.; Saleh, Ashraf Nabil; Fathallah, M.

doi:10.21608/asmj.2021.167324

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…These trials included 17 [ 31 ] to 62 [ 1 ] participants. These studies were published between 2007 and 2021 and were conducted in Iran (one study) [ 32 ], Egypt (two studies) [ 24 , 29 ], China (one study) [ 1 ], Turkey (one study) [ 31 ], and India (one study) [ 30 ]. The participants’ mean age ranged from 26.23 [ 29 ] to 40.06 [ 32 ] years.…”

Section: Resultsmentioning

confidence: 99%

“…According to the present systematic review and meta-analysis, theophylline/aminophylline was effective in reducing pain severity after PDPH onset. These methylxanthines are superior to acetaminophen [ 24 ], conservative treatment (comprising caffeine) [ 30 ], and placebo for pain relief in PDPH. Furthermore, no adverse effects were reported following aminophylline/theophylline administration in these patients [ 10 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…1 and 2 show the risk of bias in individual trials and the risk of each bias among all trials, respectively. Eight studies described the method of assigning participants to the intervention and control groups by random sequence generation [10,11,19,[23][24][25][26][27], whereas the others did not provide a complete explanation. Allocation concealment was reported in only three studies [1,28,29] and four trials were not blinded [26,27,[29][30][31].…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Except for one study [32], the other studies were judged to be at low risk for selective reporting. Ultimately, eight studies were deemed to be at low risk [1,10,11,[23][24][25]28,33], three at high risk [30][31][32], and four at unclear risk of bias [26,27,29,34].…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

et al. 2023

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Background: Post-dural puncture headache (PDPH) is one of the most common complications in patients undergoing spinal anesthesia. The present systematic review and meta-analysis aimed to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH.Methods: Relevant studies were identified by searching the following electronic databases, without language restriction, until June 2020: Scopus, EMBASE, MEDLINE, Google Scholar, Web of Science, Cochrane Library-CENTRAL, and CINAHL Complete. Random effects models were used to calculate the standardized mean difference (SMD) and risk ratios (RRs) with 95% confidence intervals (95% CI) to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH, respectively. The Cochrane tool was used for the quality assessment of the included studies. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation method.Results: Of the 1,349 initial records, 15 met our eligibility criteria (6 studies on therapeutic and 9 on prophylactic effects). A significant reduction in the pain score was observed following aminophylline/theophylline treatment (SMD = –1.67; 95% CI, –2.28 to –1.05; P < 0.001, I2 = 84.7%; P < 0.001). Subgroup analysis revealed that the therapeutic effect was significantly higher when these agents were compared to placebo than when conventional therapies were used. The risk of PDPH after aminophylline administration was not significantly reduced (RR = 0.74; 95% CI, 0.42 to 1.31; P = 0.290).Conclusions: Theophylline and aminophylline have therapeutic, but not prophylactic, effects on PDPH.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

et al. 2023

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Lumbar Puncture Complications: A Review of Current Literature

Reis,

Spano,

Davis-Hayes

et al. 2024

Curr Pain Headache Rep

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Is theophylline more effective than sumatriptan in the treatment of post-dural puncture headache? A randomized clinical trial

Shaat

Abdalgaleil

2021

Egyptian Journal of Anaesthesia

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Objectives: To compare the safety and efficacy of oral theophylline versus oral sumatriptan in the treatment of post-dural puncture headache (PDPH). Background: PDPH is the most frequent complication of procedures associated with a dural puncture for spinal anaesthesia, cerebrospinal fluid (CSF) sampling, or following inadvertent dural puncture during epidural anaesthesia. Since invasive treatments have known complications, pharmacologic management may be preferable. Patients and Methods: This was a prospective, randomized, double-blind, phase four, comparative clinical trial; carried out on 60 patients presented with PDPH at Damanhour Teaching Hospital, El Beheira, Egypt; between February 2020 and May 2021. Patients were randomly allocated into two equal groups; group T, which received oral theophylline, and group S, which received oral sumatriptan. Results: There were no statistically significant differences between both groups as regards: demographic data, American Society of Anesthesiologists (ASA) physical status, type of operation, type, and size of the spinal needle. PDPH duration and length of hospital stay were significantly shorter in group T than in group S. Numerical pain rating scale (NPRS) scores were significantly lower in group T than in group S. Palpitation, dizziness, gastric irritation, and nausea/vomiting occurred in both groups with no statistically significant differences. No patient in either group needed an epidural blood patch. Conclusion:Oral theophylline is more effective and safer than oral sumatriptan in the treatment of PDPH. It lowered NPRS scores, shortened the duration of PDPH, and length of hospital stay, and was associated with minimal side effects.

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Aminophylline Versus Acetaminophen in the Treatment of Post-Dural Puncture Headache

Cited by 3 publications

References 12 publications

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

Post-dural puncture headache prevention and treatment with aminophylline or theophylline: a systematic review and meta-analysis

Lumbar Puncture Complications: A Review of Current Literature

Is theophylline more effective than sumatriptan in the treatment of post-dural puncture headache? A randomized clinical trial

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