Tramadol for postdural puncture headache treatment in a pediatric patient following failed blood patch

Evidence-Based Practice Recommendations to Prevent/Manage Post-Lumbar Puncture Headaches in Pediatric Patients Receiving Intrathecal Chemotherapy

“…One of these, a non-randomized pilot study found no statistical significance for the use of frovatriptan, an anti-migraine medication, in reducing the duration of PLPHs (Bussone et al, 2007). Three case reports assessed other interventions including tramadol, oral and intravenous hydration, caffeine, ibuprofen, and acetaminophen (Liley, Manoharan, & Upadhyay, 2003; Raiger, Naithani, Gupta, & Pareek, 2012; Stephenson, Varness, Schroeder, & Ford, 2012). One case study found these interventions to be ineffective and the patient required an epidural blood patch to relieve the PLPH (Liley et al, 2003).…”

It is wrong to treat pain in CSF hypotension headache to allow the patient to walk!

“…Numerous published articles are bringing different alternatives in an attempt to treat a postural headache that is pathognomonic of cerebrospinal fluid (CSF) hypotension (Table 1). [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Even so, one of the most used drugs to prevent and treat post-lumbar puncture headache, caffeine, had its analgesic action questioned in a publication of notable reputation due to being insufficiently supported by the available pharmacological and clinical proofs. 24 In the intracranial space, there are three compartments: CSF, brain parenchyma, and blood.…”