Effects of Oral Caffeine on Postdural Puncture Headache A Double-Blind, Placebo-Controlled Trial

Camman, W. R.; Murray, Scott; Mushlin, Phillip S.; Lambert, Donald H.; Dewan, David M.

doi:10.1097/00132582-199010000-00052

Cited by 42 publications

(55 citation statements)

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“…IV theophylline also reduced the severity of PDPH (Ergun et al, 2008 Level II). Oral caffeine reduced the severity PDPH at 4 hours (Camann et al, 1990 Level II) but did not reduce the rate of EBP administration (Candido & Stevens, 2003;Halker et al, 2007).…”

Section: Other Treatmentsmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Other Treatmentsmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…Relative cerebrospinal fluid hypovolaemia [33] which results in painful possibly adenosine receptor mediated [34] cerebral vasodilatation. It is then responsible for the headache.…”

Section: Pathophysiologymentioning

confidence: 99%

Perioperative Management of post dural puncture headache

Shaikh¹,

Ramesh²

2015

Int J of Biomed & Adv Res

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Post dural puncture headache (PDPH) is a common complication of interventional neuraxial procedures. It carries a considerable morbidity with symptoms lasting for several days, sometimes severe enough to immobilise the patient. If left untreated it can result in serious complication which may be fatal. It is therefore important that the doctors should aware of the methods available for reducing the incidence of PDPH. This article reviews the scientific literature involved in the management of PDPH including the epidural blood patch.

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“…This causes sagging of intracranial structure, with consequent traction on pain-sensitive structures (such as meninges, cranial nerves, and veins) [ 156 ]. The second hypothesis suggests that decreased CSF pressure leads to intrathecal hypotension and painful vasodilatation of the intracranial blood vessels (known as the "intracranial vascular response") [ 157 ]. Mainly when the patient is in a standing position, painful areas dilate (meninges, tentorium, vessels), and there is further pain transmission via the cerebral nerves and upper cervical nerves.…”

Section: Post-dural Puncture Headache (Pdph)mentioning

confidence: 99%